{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:06:22Z","timestamp":1779080782572,"version":"3.51.4"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancer cases, and minimally invasive lobectomy is a standard curative approach for early-stage disease. The comparative perioperative outcomes of Robot-assisted thoracoscopic surgery (RATS) and Video-assisted thoracoscopic surgery (VATS) remain controversial. This meta-analysis compared perioperative outcomes of RATS and VATS for NSCLC using real-world clinical studies while excluding database-based analyses to better reflect routine practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Library, and Web of Science were searched for English-language studies published from January 2016 to December 2025. Eligible studies were real-world clinical reports directly comparing RATS with VATS in NSCLC; database analyses and clinical trials were excluded. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle\u2013Ottawa Scale (NOS). Meta-analysis was performed with Review Manager 5.3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine studies were included (7 high-quality and 2 moderate-quality), involving 2, 130 patients with NSCLC (RATS: 1, 090; VATS: 1, 040). Pooled analyses showed no significant differences between RATS and VATS in intraoperative blood loss, postoperative length of stay, or postoperative complication rates. RATS was associated with a higher lymph node yield than VATS (weighted mean difference, +2.38). In the lobectomy subgroup, operative time and postoperative length of stay were shorter with RATS. Funnel plots did not suggest substantial publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on real-world clinical evidence, RATS and VATS achieve comparable perioperative safety and short-term outcomes in NSCLC. RATS is associated with greater lymph node retrieval and may be a reasonable option when nodal yield is prioritized, particularly for patients undergoing lobectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1835395","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:18:07Z","timestamp":1779077887000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative outcomes of robot-assisted versus video-assisted thoracoscopic surgery for non-small cell lung cancer: a meta-analysis focusing on real-world clinical studies in the past 10 years"],"prefix":"10.3389","volume":"16","author":[{"given":"Jianfang","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shaoxing Second Hospital","place":["Shaoxing, Zhejiang, 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