{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:10:23Z","timestamp":1756458623194,"version":"3.44.0"},"reference-count":48,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chinese National Railway Group\u2019s 2023 Medical and Health Special Scientific Research Project Plan","award":["J2023Z613"],"award-info":[{"award-number":["J2023Z613"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>This meta-analysis aimed to evaluate differences in perioperative outcomes and costs between robotic-assisted partial pulmonary resection (RAPPR) and video-assisted thoracoscopic partial pulmonary resection (VATPPR).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>We systematically searched MEDLINE, PubMed, Google Scholar, and Cochrane databases for relevant studies published between March 2015 and March 2025. Propensity score-matched non-randomized controlled studies comparing RAPPR with VATPPR were included.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>Eight propensity score-matched studies involving 3,104 patients were included: 1,528 patients underwent RAPPR and 1,576 underwent VATPPR. RAPPR was associated with longer operative time and higher medical costs, but patients had more lymph nodes dissected, shorter drainage tube duration, and shorter hospital length of stay. No significant differences were observed between the two groups in conversion to thoracotomy rates or complication rates, including persistent air leak, pneumonia, and chylothorax.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusions<\/jats:title>\n               <jats:p>RAPPR demonstrates comparable surgical efficacy to VATPPR with advantages including more thorough lymph node dissection, earlier drainage tube removal, and earlier patient discharge. However, RAPPR requires longer operative time and higher costs. The choice between surgical approaches should consider these clinical factors comprehensively.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.19911","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:28:52Z","timestamp":1756456132000},"page":"e19911","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of efficacy and costs between robotic-assisted and conventional thoracoscopic approaches for partial pulmonary resection: a systematic review and meta-analysis of propensity score-matched studies"],"prefix":"10.7717","volume":"13","author":[{"given":"Xinyang","family":"Huang","sequence":"first","affiliation":[{"name":"Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoxuan","family":"Li","sequence":"additional","affiliation":[{"name":"School of Basic Medicine, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihao","family":"Deng","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyuan","family":"Tian","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunjiang","family":"Zhong","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xugang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"1","key":"10.7717\/peerj.19911\/ref-1","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s00464-021-08338-9","article-title":"A national database propensity score-matched comparison of minimally invasive and open colectomy for long-term opioid use","volume":"36","author":"Bastawrous","year":"2022","journal-title":"Surgical Endoscopy"},{"issue":"4","key":"10.7717\/peerj.19911\/ref-2","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.jval.2015.12.019","article-title":"A multidimensional analysis of prostate surgery costs in the united states: robotic-assisted versus retropubic radical prostatectomy","volume":"19","author":"Bijlani","year":"2016","journal-title":"Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research"},{"key":"10.7717\/peerj.19911\/ref-3","doi-asserted-by":"publisher","first-page":"107903","DOI":"10.1016\/j.lungcan.2024.107903","article-title":"1000 robotic-assisted lobectomies for primary lung cancer: 16 years single center experience","volume":"195","author":"Casiraghi","year":"2024","journal-title":"Lung Cancer"},{"issue":"3","key":"10.7717\/peerj.19911\/ref-4","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1007\/s13304-021-00992-x","article-title":"Comparative short-term outcomes of robotic-assisted surgery for older patients with non-small cell lung cancer: a propensity matched study","volume":"74","author":"Chen","year":"2022","journal-title":"Updates in Surgery"},{"issue":"4","key":"10.7717\/peerj.19911\/ref-5","doi-asserted-by":"publisher","first-page":"e176233","DOI":"10.1001\/jamasurg.2017.6233","article-title":"Understanding costs of care in the operating room","volume":"153","author":"Childers","year":"2018","journal-title":"JAMA Surgery"},{"key":"10.7717\/peerj.19911\/ref-6","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1515\/med-2019-0081","article-title":"Evaluation of surgical site infection in mini-invasive urological surgery","volume":"14","author":"De\u00a0Vermandois","year":"2019","journal-title":"Open Medicine"},{"issue":"35","key":"10.7717\/peerj.19911\/ref-7","doi-asserted-by":"publisher","first-page":"e7633","DOI":"10.1097\/MD.0000000000007633","article-title":"Robotic versus thoracoscopic lung resection: a systematic review and meta-analysis","volume":"96","author":"Emmert","year":"2017","journal-title":"Medicine"},{"issue":"8","key":"10.7717\/peerj.19911\/ref-8","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1007\/s11748-019-01277-2","article-title":"Lobe-specific outcomes of surgery for lung cancer patients with idiopathic interstitial pneumonias","volume":"68","author":"Fukui","year":"2020","journal-title":"General Thoracic and Cardiovascular Surgery"},{"issue":"5","key":"10.7717\/peerj.19911\/ref-9","doi-asserted-by":"publisher","first-page":"ezae389","DOI":"10.1093\/ejcts\/ezae389","article-title":"Early outcomes of robotic versus video-thoracoscopic anatomical segmentectomy: a propensity score-matched real-world study","volume":"66","author":"G\u00f3mez-Hern\u00e1ndez","year":"2024","journal-title":"European Journal of Cardio-Thoracic Surgery"},{"issue":"6","key":"10.7717\/peerj.19911\/ref-10","doi-asserted-by":"publisher","first-page":"e62958","DOI":"10.7759\/cureus.62958","article-title":"Role of robotic-assisted surgery in public health: its advantages and challenges","volume":"16","author":"Handa","year":"2024","journal-title":"Cureus"},{"issue":"12","key":"10.7717\/peerj.19911\/ref-11","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1093\/jjco\/hyad110","article-title":"A multicenter propensity score-matched analysis of lymphadenectomy in N1-positve lung cancer","volume":"53","author":"Handa","year":"2023","journal-title":"Japanese Journal of Clinical Oncology"},{"issue":"8","key":"10.7717\/peerj.19911\/ref-12","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1007\/s00595-025-02992-5","article-title":"Clinicopathological features and perioperative outcomes of robot-assisted thoracoscopic surgery for primary lung cancer: an analysis of initial outcomes based on the national clinical database","volume":"55","author":"Haruki","year":"2025","journal-title":"Surgery Today"},{"issue":"5","key":"10.7717\/peerj.19911\/ref-13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/rcs.2123","article-title":"Perioperative outcomes of robot-assisted vs video-assisted and traditional open thoracic surgery for lung cancer: A systematic review and network meta-analysis","volume":"16","author":"Hu","year":"2020","journal-title":"The International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS"},{"issue":"3","key":"10.7717\/peerj.19911\/ref-14","doi-asserted-by":"publisher","first-page":"169","DOI":"10.2174\/1386207322666190411113040","article-title":"Efficacy and safety of robot-assisted thoracic surgery (RATS) compare with video-assisted thoracoscopic surgery (VATS) for lung lobectomy in patients with non-small cell lung cancer","volume":"22","author":"Hu","year":"2019","journal-title":"Combinatorial Chemistry & High Throughput Screening"},{"issue":"11","key":"10.7717\/peerj.19911\/ref-15","doi-asserted-by":"publisher","first-page":"3354","DOI":"10.3390\/jcm13113354","article-title":"Recent advancements in minimally invasive surgery for early stage non-small cell lung cancer: a narrative review","volume":"13","author":"Khan","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"20","key":"10.7717\/peerj.19911\/ref-16","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1111\/1759-7714.15379","article-title":"Early patient-reported outcomes after robotic-assisted versus video-assisted thoracoscopic lobectomy","volume":"15","author":"Lan","year":"2024","journal-title":"Thoracic Cancer"},{"key":"10.7717\/peerj.19911\/ref-17","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1136\/bmj.333.7568.597","article-title":"The case of the misleading funnel plot","volume":"333","author":"Lau","year":"2006","journal-title":"BMJ"},{"issue":"6","key":"10.7717\/peerj.19911\/ref-18","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Statistical Methods in Medical Research"},{"key":"10.7717\/peerj.19911\/ref-19","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1186\/s12885-021-08241-5","article-title":"Robot-assisted thoracic surgery versus video-assisted thoracic surgery for lung lobectomy or segmentectomy in patients with non-small cell lung cancer: a meta-analysis","volume":"21","author":"Ma","year":"2021","journal-title":"BMC Cancer"},{"issue":"9","key":"10.7717\/peerj.19911\/ref-20","doi-asserted-by":"publisher","first-page":"3883","DOI":"10.21037\/tcr-21-646","article-title":"Robotic and video-assisted lobectomy\/segmentectomy for non-small cell lung cancer have similar perioperative outcomes: a systematic review and meta-analysis","volume":"10","author":"Mao","year":"2021","journal-title":"Translational Cancer Research"},{"issue":"5","key":"10.7717\/peerj.19911\/ref-21","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1016\/s1010-7940(02)00102-1","article-title":"Early experience with robotic technology for thoracoscopic surgery","volume":"21","author":"Melfi","year":"2002","journal-title":"European Journal of Cardio-Thoracic Surgery"},{"key":"10.7717\/peerj.19911\/ref-22","doi-asserted-by":"publisher","first-page":"1005860","DOI":"10.3389\/fsurg.2022.1005860","article-title":"Early experience with uniportal robotic thoracic surgery lobectomy","volume":"9","author":"Mercadante","year":"2022","journal-title":"Frontiers in Surgery"},{"issue":"4","key":"10.7717\/peerj.19911\/ref-23","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1055\/s-0041-1728707","article-title":"Video-assisted thoracoscopic surgery lung resection in united states veterans: trends and outcomes versus thoracotomy","volume":"70","author":"Napolitano","year":"2022","journal-title":"The Thoracic and Cardiovascular Surgeon"},{"key":"10.7717\/peerj.19911\/ref-24","doi-asserted-by":"publisher","first-page":"3840","DOI":"10.21037\/jtd-23-377","article-title":"Robot-assisted thoracic surgery versus video-assisted thoracic surgery for mediastinal lesions","volume":"15","author":"Ochi","year":"2023","journal-title":"Journal of Thoracic Disease"},{"key":"10.7717\/peerj.19911\/ref-25","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"6)","key":"10.7717\/peerj.19911\/ref-26","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1097\/SLA.0000000000006073","article-title":"Robotic lobectomy is cost-effective and provides comparable health utility scores to video-assisted lobectomy: early results of the RAVAL trial","volume":"278","author":"Patel","year":"2023","journal-title":"Annals of Surgery"},{"issue":"3","key":"10.7717\/peerj.19911\/ref-27","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1016\/j.jtcvs.2019.10.158","article-title":"Robotic sleeve lobectomy for centrally located non-small cell lung cancer: a propensity score-weighted comparison with thoracoscopic and open surgery","volume":"160","author":"Qiu","year":"2020","journal-title":"The Journal of Thoracic and Cardiovascular Surgery"},{"issue":"5","key":"10.7717\/peerj.19911\/ref-28","doi-asserted-by":"publisher","first-page":"397","DOI":"10.3978\/j.issn.2227-684X.2015.04.08","article-title":"Robotic transaxillary thyroid surgery","volume":"4","author":"Rabinovics","year":"2015","journal-title":"Gland Surgery"},{"issue":"6","key":"10.7717\/peerj.19911\/ref-29","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1007\/s11701-022-01377-x","article-title":"Is robotic lobectomy cheaper? A micro-cost analysis","volume":"16","author":"Shanahan","year":"2022","journal-title":"Journal of Robotic Surgery"},{"issue":"6)","key":"10.7717\/peerj.19911\/ref-30","doi-asserted-by":"publisher","first-page":"3189","DOI":"10.1007\/s00464-021-08322-3","article-title":"Repeated partial tissue bite with inadequate cooling time for an energy device may cause thermal injury","volume":"35","author":"Shibao","year":"2021","journal-title":"Surgical Endoscopy"},{"issue":"4","key":"10.7717\/peerj.19911\/ref-31","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1089\/end.2019.0788","article-title":"Robot-assisted radical prostatectomy associated with decreased persistent postoperative opioid use","volume":"34","author":"Shkolyar","year":"2020","journal-title":"Journal of Endourology"},{"issue":"11","key":"10.7717\/peerj.19911\/ref-32","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/s0895-4356(00)00242-0","article-title":"Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature","volume":"53","author":"Sterne","year":"2000","journal-title":"Journal of Clinical Epidemiology"},{"issue":"10","key":"10.7717\/peerj.19911\/ref-33","doi-asserted-by":"publisher","first-page":"5700","DOI":"10.21037\/jtd-23-582","article-title":"Long-term outcomes of robotic versus video-assisted pulmonary lobectomy for non-small cell lung cancer: systematic review and meta-analysis of reconstructed patient data","volume":"15","author":"Tasoudis","year":"2023","journal-title":"Journal of Thoracic Disease"},{"issue":"5","key":"10.7717\/peerj.19911\/ref-34","doi-asserted-by":"publisher","first-page":"e248881","DOI":"10.1001\/jamanetworkopen.2024.8881","article-title":"Video-assisted vs robotic-assisted lung lobectomies for operating room resource utilization and patient outcomes","volume":"7","author":"Tupper","year":"2024","journal-title":"JAMA Network Open"},{"issue":"3","key":"10.7717\/peerj.19911\/ref-35","doi-asserted-by":"publisher","first-page":"464","DOI":"10.18999\/nagjms.86.3.464","article-title":"Incidence of air leaks in patients undergoing robotic thoracic surgery and video-assisted thoracic surgery","volume":"86","author":"Ueno","year":"2024","journal-title":"Nagoya Journal of Medical Science"},{"issue":"13","key":"10.7717\/peerj.19911\/ref-36","doi-asserted-by":"publisher","first-page":"3442","DOI":"10.3390\/cancers15133442","article-title":"A comparison of total thoracoscopic and robotic surgery for lung cancer lymphadenectomy","volume":"15","author":"Ure\u00f1a","year":"2023","journal-title":"Cancer"},{"issue":"1","key":"10.7717\/peerj.19911\/ref-37","doi-asserted-by":"publisher","first-page":"25-0039","DOI":"10.70352\/scrj.cr.25-0039","article-title":"Robotic segmentectomy in a patient with a displaced left upper division bronchus and fused fissure","volume":"11","author":"Wada","year":"2025","journal-title":"Surgical Case Reports"},{"issue":"2","key":"10.7717\/peerj.19911\/ref-38","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1177\/1556984521992384","article-title":"Robotic-assisted complex pulmonary resection: sleeve lobectomy for cancer","volume":"16","author":"Watkins","year":"2021","journal-title":"Innovations"},{"issue":"1","key":"10.7717\/peerj.19911\/ref-39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21037\/acs-2022-urats-14","article-title":"The learning curve of the robotic-assisted lobectomy-a systematic review and meta-analysis","volume":"12","author":"Wilson-Smith","year":"2023","journal-title":"Annals of Cardiothoracic Surgery"},{"key":"10.7717\/peerj.19911\/ref-40","doi-asserted-by":"publisher","first-page":"661821","DOI":"10.3389\/fonc.2021.661821","article-title":"Comparison of perioperative outcomes between precise and routine segmentectomy for patients with early-stage lung cancer presenting as ground-glass opacities: A propensity score-matched study","volume":"11","author":"Wu","year":"2021","journal-title":"Frontiers in Oncology"},{"issue":"20","key":"10.7717\/peerj.19911\/ref-41","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1111\/1759-7714.14938","article-title":"Perioperative outcomes of robotic-assisted versus video-assisted thoracoscopic lobectomy: a propensity score matched analysis","volume":"14","author":"Wu","year":"2023","journal-title":"Thoracic Cancer"},{"issue":"2","key":"10.7717\/peerj.19911\/ref-42","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1093\/ejcts\/ezx310","article-title":"Early outcomes of robotic versus uniportal video-assisted thoracic surgery for lung cancer: a propensity score-matched study","volume":"53","author":"Yang","year":"2018","journal-title":"European Journal of Cardio-Thoracic Surgery"},{"issue":"2","key":"10.7717\/peerj.19911\/ref-43","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1097\/SLA.0000000000001708","article-title":"Long-term survival based on the surgical approach to lobectomy for clinical stage I nonsmall cell lung cancer: comparison of robotic, video-assisted thoracic surgery, and thoracotomy lobectomy","volume":"265","author":"Yang","year":"2017","journal-title":"Annals of Surgery"},{"issue":"20","key":"10.7717\/peerj.19911\/ref-44","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1111\/1759-7714.15377","article-title":"Is wedge resection equivalent to segmentectomy in pathological stage IA (\u22642 cm) non-small cell lung cancers?","volume":"15","author":"Zhang","year":"2024","journal-title":"Thoracic Cancer"},{"issue":"9","key":"10.7717\/peerj.19911\/ref-45","doi-asserted-by":"publisher","first-page":"108481","DOI":"10.1016\/j.ejso.2024.108481","article-title":"Comparison of early postoperative patient-reported outcomes after multiportal robotic-assisted thoracoscopic surgery and uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer","volume":"50","author":"Zhang","year":"2024","journal-title":"European Journal of Surgical Oncology: The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology"},{"issue":"1","key":"10.7717\/peerj.19911\/ref-46","doi-asserted-by":"publisher","first-page":"e63","DOI":"10.1016\/j.cllc.2024.10.004","article-title":"Comparison of long-term survival between robotic and video-assisted lobectomy for stage I NSCLC with radiologic solid tumors: a propensity score matching study","volume":"26","author":"Zhang","year":"2025","journal-title":"Clinical Lung Cancer"},{"issue":"3","key":"10.7717\/peerj.19911\/ref-47","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1016\/j.athoracsur.2021.03.068","article-title":"Robotic surgery and anatomic segmentectomy: an analysis of trends, patient selection, and outcomes","volume":"113","author":"Zhou","year":"2022","journal-title":"The Annals of Thoracic Surgery"},{"issue":"34","key":"10.7717\/peerj.19911\/ref-48","doi-asserted-by":"publisher","first-page":"3221","DOI":"10.3760\/cma.j.cn112137-20240226-00410","article-title":"Comparison of the efficacy of robot assisted and thoracoscopic assisted thoracic surgery in non-small cell lung cancer","volume":"104","author":"Zhou","year":"2024","journal-title":"Zhonghua Yi Xue Za Zhi"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/19911.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19911.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19911.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19911.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:28:55Z","timestamp":1756456135000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/19911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":48,"alternative-id":["10.7717\/peerj.19911"],"URL":"https:\/\/doi.org\/10.7717\/peerj.19911","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]},"article-number":"e19911"}}