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With increased detection via low-dose CT screening, the demand for segmentectomy is rising. This retrospective cohort study compared short-term outcomes, complications, and costs between robot-assisted segmentectomy (RAS) and video-assisted segmentectomy (VAS) in NSCLC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A sum of 603 patients with pathologically confirmed NSCLC who underwent segmentectomy at Xiangya Hospital between May 2020 and June 2024 were included: RAS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009302), VAS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009301). Both groups were comparable in demographics and baseline characteristics. Intraoperative variables, postoperative recovery indicators, lung function (pre- and postoperative), hemoglobin levels, arterial blood gases, and total cost were analyzed. Statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No 30-day mortality occurred in either group. RAS showed significantly shorter operation time (89.53\u2009\u00b1\u200926.60\u00a0min vs. 107.80\u2009\u00b1\u200943.92\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), faster intersegmental plane identification (6.10\u2009\u00b1\u20091.02\u00a0min vs. 14.07\u2009\u00b1\u20092.69\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), less blood loss (47.3\u2009\u00b1\u200939.7\u00a0ml vs. 57.3\u2009\u00b1\u200964.7\u00a0ml,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.022), shorter hospital stay (7.9\u2009\u00b1\u20092.0 vs. 8.5\u2009\u00b1\u20093.6 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.013), chest tube duration (3.3\u2009\u00b1\u20091.1 vs. 3.6\u2009\u00b1\u20091.3 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.003), and POD1 drainage (257.6\u2009\u00b1\u2009100.4 vs. 282.0\u2009\u00b1\u2009118.4\u00a0ml,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.006). RAS had fewer conversions (0.66% vs. 1.3%) and higher lymph node sampling (4.9\u2009\u00b1\u20090.1 vs. 4.1\u2009\u00b1\u20090.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Minor (13.57% vs. 19.93%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0387) and major (9.60% vs. 12.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.035) complications, postoperative pain (1.65% vs. 7.98%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0002), cough, opioid (20% vs. 58%) and antitussive use (20% vs. 46.2%) were lower in RAS. Lung function and ABG values and haemoglobin were statistically similar. Total cost was significantly higher in RAS (9422.3\u2009\u00b1\u20093183.0 vs. 5741.4\u2009\u00b1\u20091223.2 USD,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RAS offers better perioperative outcomes and lower morbidity than VAS but at significantly higher cost, requiring further strategies for cost optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-025-03421-7","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T13:03:21Z","timestamp":1766149401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally invasive segmentectomy for non-small cell lung cancer (NSCLC): a comparative analysis of robotic and thoracoscopic approaches"],"prefix":"10.1186","volume":"26","author":[{"given":"Zeeshan","family":"Malik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanwu","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"issue":"3","key":"3421_CR1","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/0003-4975(95)00537-U","volume":"60","author":"RJ Ginsberg","year":"1995","unstructured":"Ginsberg RJ, Rubinstein LV. 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