Robot-Assisted Thoracic Surgery for benign tumors at the cervicothoracic junction：A retrospective study

Abstract BACKGROUND The objective of this study was to evaluate the feasibility and safety of robot-assisted thoracic surgery (RATS) using the da Vinci robotic system for benign tumors of the cervicothoracic junction resection, and to describe the patients' postoperative health-related quality of life. METHODS This retrospective analysis included 46 patients who underwent RATS for benign cervicothoracic junction tumors between April 2017 and December 2021. Clinical data, including manifestation, surgical technique, morbidity, resection degree, outcome, and pathological types, were collected. We administered the EQ-5D-5L questionnaire to assess patients' postoperative health-related quality of life. RESULTS All patients underwent successful resection of a benign tumor at the cervicothoracic junction with no intraoperative complications. The median operation time was 105 min, median duration of the chest tube was 1 d, and median postoperative hospital stay was 2 days. Four (8.7%) patients developed postoperative complications. The 3-year overall survival rate was 100% and the 5-year overall survival rate was 87.5%. An elderly patient died 56 months after surgery due to heart attack. No recurrence was found during the follow-up. For health-related quality of life, the mean EQ-5D-5L index for all patients was 0.808. Tumor sizes larger than 5 cm(mean ± SD = 0.768 ± 0.111, F = 5.173, p = 0.028) and neurogenic tumors (mean ± SD = 0.702 ± 0.082, F=-16.143, p < 0.001) remained significantly independently associated with a lower EQ-5D-5L index. CONCLUSION This study demonstrated that robot-assisted thoracic surgery for benign tumors of the cervicothoracic junction is a safe and technically feasible procedure, especially for tumors < 5 cm and non-neurogenic tumors.