Robotic chest wall resection for primary benign chest wall tumors and locally advanced lung cancer: an institutional case series and national report

Background: Limited data exists for robotic chest wall resection; we report institutional and national experience of robotic chest wall resection. Methods: In this comparative retrospective case series we describe patients who underwent robotic chest wall resection at our institution and enrich this case series with data from the National Cancer Database (NCDB). We describe our preoperative workup, operative technique, and postoperative care. Outcomes included conversion to open, length of stay, readmissions, and 30- and 90-day mortality. The results are descriptively reported and compared. Results: We describe 6 patients institutionally and 96 NCDB patients. At our institution 66.7% were males, median age was 70.0 (range, 39-91) years, and 50% were primary chest wall tumors. Median tumor size was 5.25 (range, 2.3-8.3) cm. Outcomes were as follows: no open conversions, median length of stay 3 (range, 1-6) days, no unplanned 30-day readmissions or 90-day mortality. In the NCDB, 55.2% were males with median age of 68.5 (range, 30-89) years. Median tumor size was 3.90 (range, 2.4-6.0) cm. NCDB outcomes were as follows: 18.8% open conversion, median length of stay 7 (range, 5-10) days, 3.1% unplanned 30-day readmission, and 8.3% 90-day mortality. Our institutional case series had 18.0 months median followup (range, 6-54 months) with no functional deficits. Median survival in NCDB was 49.6 months. Conclusions: Robotic chest wall resection is feasible and is performed nationally with acceptable shortand long-term outcomes. Our institutional experience reports our technique, resultant short hospital stay, and excellent functional outcomes.