[Observational studies to evaluate robotic-assisted lung cancer surgery?]

Background: The aim of this work is to assess the quality of observational studies and to make direct and indirect comparisons of robotic surgery with other approaches.
Method: We searched various databases between 2014 and 2024 for observational studies comparing robotic-assisted surgery to thoracoscopy or thoracotomy.
Results: Eighteen studies were included in the meta-analysis. Risk of confounding bias was present in 90% of studies, while risk of classification bias appeared in 80%. Robotic-assisted surgery reduced the risk of conversion to thoracotomy compared with thoracoscopy with an odds ratio of 0.21 (95% confidence interval: 0.06-0.65), with high heterogeneity between studies (I ² =80%). Robotic-assisted surgery did not significantly reduce postoperative complications or 30-day mortality compared with thoracotomy or thoracoscopy. For 5-year overall survival, comparisons of robotic-assisted surgery to thoracoscopy or thoracotomy were non-significant with I ² of 55%.
Conclusion: This work demonstrates the need for a randomized controlled trial to validate robotic surgery for the treatment of bronchial cancer.
(Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)