Assessment of Modified Textbook Outcome Achievement after Dual-Port versus Multi-Port Robotic Anatomical Lung Resection: A Propensity-Matched Observational Study.

Authors

Jun Suzuki, Hikaru Watanabe, Satoshi Takamori, Hiroki Ebana, Tetsuro Uchida, Satoshi Shiono

Published in

Journal of chest surgery. Sep 30, 2026. Epub Sep 30, 2026.

Abstract

Reduced-port robotic thoracic surgery is intended to reduce access-related trauma while preserving procedural quality. This study compared dual-port and conventional multi-port robotic anatomical lung resection using modified Textbook Outcome (TO) achievement as a composite perioperative quality metric.
Consecutive patients who underwent robotic-assisted lobectomy or segmentectomy for lung cancer or metastatic lung tumors between January 2022 and December 2024 were retrospectively reviewed. Dual-port robotic-assisted thoracic surgery (D-RATS) was compared with multi-port robotic-assisted thoracic surgery (M-RATS). The primary endpoint was modified TO achievement, defined using 9 perioperative criteria. One-to-one propensity-score matching was performed using preoperative variables, including demographics, pulmonary function, comorbidity burden, tumor size, and procedure type.
Among 171 eligible patients, including 88 who underwent D-RATS and 83 who underwent M-RATS, propensity-score matching yielded 61 well-balanced pairs. In the matched cohort, modified TO was achieved in 42/61 patients (68.8%) in the D-RATS group and 41/61 patients (67.2%) in the M-RATS group (absolute difference, 1.6%; matched odds ratio, 1.07; 95% confidence interval, 0.49-2.36; p=0.85). Median operative time (151 minutes vs. 162 minutes, p=0.16) and median blood loss (10 mL vs. 10 mL, p=0.72) were similar between groups. Median chest drain duration was 1 day in both groups, but the distribution was narrower in the D-RATS group (1 [interquartile range, 1-1] days vs. 1 [interquartile range, 1-2] days, p=0.001).
In this propensity-matched cohort, D-RATS maintained perioperative quality comparable to that of conventional M-RATS when assessed using modified TO achievement, without compromising procedural efficiency.

PMID:
42811761
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

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