{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:41:43Z","timestamp":1792737703999,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study examined the association of surgical approach with operative and postoperative outcomes as well as margin and nodal outcomes after complex segmentectomy, comparing mini-thoracotomy (MT) with multiportal minimally invasive thoracic surgery (mMITS) and, within mMITS, video-assisted thoracic surgery (mVATS) with multiportal robot-assisted thoracic surgery (mRATS), using propensity score matching (PSM). The study cohort comprised 808 consecutive patients treated with complex segmentectomy for suspected malignant pulmonary tumors from January 2015 through July 2026. Of these, 138 underwent MT and 670 mMITS, including 605 mVATS and 65 mRATS. PSM (1:2) was performed for MT versus mMITS (n\u2009=\u2009126 vs. 252) and mVATS versus mRATS (n\u2009=\u2009126 vs. 63). We assessed operative outcomes, postoperative complications, pain-related outcomes only for the mVATS\u2013mRATS comparison, and margin and nodal outcomes. Blood loss was lower with mMITS than with MT (5 vs. 20 mL, p\u2009&lt;\u20090.001), and chest tube duration was shorter (p\u2009=\u20090.002). Margin and nodal outcomes did not differ significantly between MT and mMITS. mRATS was associated with less blood loss than mVATS (3 vs. 5 mL, p\u2009=\u20090.006), a shorter duration of regular oral analgesic use (20 vs. 31 days, p\u2009=\u20090.007), and greater hilar and mediastinal lymph node yields (hilar, p\u2009=\u20090.037; mediastinal, p\u2009=\u20090.025). For complex segmentectomy, mMITS was associated with less blood loss and shorter chest tube duration than MT, without significant differences in margin and nodal outcomes. Within mMITS, mRATS was associated with shorter regular oral analgesic use and greater hilar and mediastinal lymph node yields than mVATS.<\/jats:p>","DOI":"10.1007\/s11701-026-04088-9","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:37:09Z","timestamp":1792737429000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term outcomes of mini-thoracotomy, multiportal video-assisted thoracic surgery, and multiportal robot-assisted thoracic surgery for complex segmentectomy"],"prefix":"10.1007","volume":"20","author":[{"given":"Tetsuya","family":"Isaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentaro","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Nishina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ogata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikki","family":"Takada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiaki","family":"Kanno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nagashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"4088_CR1","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1016\/S0140-6736(21)02333-3","volume":"399","author":"H Saji","year":"2022","unstructured":"Saji H, Okada M, Tsuboi M et al (2022) Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802\/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. 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The investigation followed the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Given the retrospective design, individual informed consent was not required. Participation was handled through an opt-out procedure.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Complex segmentectomy included segmentectomies other than superior segmentectomy (S6), basal segmentectomy, lingulectomy, and upper-division segmentectomy. Representative examples include right S3, right S10, left S1\u2009+\u20092, and left S8.","order":4,"name":"Ethics","label":"Supplementary Fig.\u00a01. Definition of complex segmentectomy","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1128"}}