Faster, Safer, Better Recovery: A Modified Robotic-Assisted Segmentectomy Versus Conventional Approaches in Early-Stage Lung Cance

Abstract Purpose The aim of this study is to evaluate the perioperative results of patients who receive robot-assisted thoracoscopic (RATS) modified segmentectomy and to compare the effectiveness and safety of this approach with those of traditional segmentectomy methods. Methods A retrospective analysis was conducted on perioperative data from 587 consecutive patients diagnosed with early-stage lung cancer who underwent robot-assisted thoracoscopic segmentectomy between January 2020 and September 2024. Using a 1:1 propensity score matching approach, 326 patients were paired based on clinical variables such as age, sex, body weight, height, pulmonary function test results, and tumor size as measured by CT. Comparative assessments of perioperative outcomes and oncological parameters were performed between the matched groups. Results Of the 587 individuals included in the study, 178 underwent conventional segmentectomy (CS), while 409 received modified segmentectomy (MS). After applying propensity score matching, a total of 328 patients were retained for the final comparative analysis. The MS group demonstrated a markedly shorter operative duration than the CS group (83.72 ± 25.46 minutes vs. 121.01 ± 35.74 minutes, P < 0.001). Although the MS group exhibited a higher mean estimated blood loss, this difference did not reach statistical significance (58.87 ± 77.57 ml vs. 44.27 ± 55.35 ml, P = 0.051). Additionally, tumor size was significantly smaller in the MS cohort (8.67 ± 2.82 mm vs. 10.41 ± 4.08 mm, P < 0.001). Complete (R0) resection was achieved in all cases. Conclusion The modified RATS segmentectomy offers significant benefits compared to conventional segmentectomy, such as shorter operative duration, improved postoperative recovery, and positive oncological results. These findings suggest that this approach may enhance both cancer control and patient recuperation, thereby supporting its wider implementation in clinical settings.