{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T04:28:24Z","timestamp":1793593704796,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Minimally invasive approaches are widely adopted for anatomical lung resection in early\u2010stage non\u2010small cell lung cancer, with video\u2010assisted thoracoscopic surgery (VATS) representing the established standard. Robotic\u2010assisted thoracoscopic surgery (RATS) has emerged as an alternative platform, although its clinical advantages remain uncertain. Persistent air leak (PAL) is a common complication following lobectomy, occurring in up to 8%\u201319% of patients and contributing to prolonged hospitalization and morbidity. Prior comparative studies of RATS and VATS have been limited by heterogeneity in operative procedures and inclusion of sublobar resections. This study aimed to compare PAL following RATS versus VATS lobectomy, restricting inclusion to lobectomy\u2010only cohorts to reduce procedural heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis of studies comparing RATS and VATS lobectomy was performed. Exclusively lobectomy\u2010only cohorts were included to reduce procedural heterogeneity. The primary outcome was PAL (&gt;\u20095\u2009days). Random\u2010effects models were used to calculate pooled risk ratios (RR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies comprising 16\u2009252 patients (RATS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092427; VATS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913\u2009825) were included. There was no significant difference in PAL between RATS and VATS (RR, 1.01; 95% CI, 0.75\u20131.37;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.93). Moderate heterogeneity was observed (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200944%). No evidence of publication bias was identified (Egger's test; intercept \u22120.54; 95% CI, \u22121.74 to 0.67;\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41). Secondary outcomes were largely comparable, although length of stay was modestly shorter following RATS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this lobectomy\u2010restricted analysis, surgical platform was not associated with differences in persistent air leak. These findings suggest that PAL is primarily driven by patient\u2010 and technique\u2010related factors rather than operative platform. Restriction to lobectomy improves comparability relative to prior studies. However, incomplete baseline reporting and observational design limit causal inference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In lobectomy\u2010only cohorts, RATS and VATS are associated with comparable rates of persistent air leak. Surgical platform alone does not appear to independently influence this outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70940","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:38:00Z","timestamp":1789454280000},"page":"3019-3027","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic\u2010 Versus Video\u2010Assisted Thoracoscopic Lobectomy and Persistent Air Leak: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4009-117X","authenticated-orcid":false,"given":"Alexander","family":"Lombardo","sequence":"first","affiliation":[{"name":"Department of Surgery Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine Ipswich Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15174281"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00173-X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1647273"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/aca.aca_139_25"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.02.17"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.10.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab376"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.853530"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2123"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-08241-5"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_9_14_1","volume-title":"The Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses","author":"Wells G. 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