| Institution: | 1. Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY;2. Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY;3. Department of Surgery, Lenox Hill Hospital/Northwell Health, New York, NY;4. Department of Pulmonary Medicine, North Shore University Hospital/Northwell Health, New York, NY;5. Department of Radiology, North Shore University Hospital/Northwell Health, New York, NY;6. Division of Thoracic Surgery, Department of Surgery, Robert Wood Johnson Barnabas Health, Long Branch, NJ;1. Unit of Thoracic Surgery, Reggio Emilia, Italy;2. Head-International Research Activities Office, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy;3. General Thoracic Surgery, “Vittorio Emanuele-Policlinico” Hospital, Catania, Italy;4. Department of General Thoracic Surgery, Catholic University of the Sacred Heart, Rome, Italy;5. Unit of Thoracic Surgery, C. Forlanini Hospital, Azienda Ospedaliera San Camillo-Forlanini Hospital, Rome, Italy;6. Unit of Thoracic Surgery, University of Turin, Turin, Italy;1. Department of Surgery, Yale University School of Medicine, New Haven, Conn;2. Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio;3. Department of Cardiothoracic Surgery, Children''s Hospital, New Orleans, La;4. Department of Thoracic Surgery, The University of Arizona College of Medicine, Tucson, Ariz;5. Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex |
| Abstract: | ObjectiveThe study objective was to examine pulmonary function and quality of life improvement after robotic-assisted thoracoscopic tracheobronchoplasty for patients with different degrees of obstructive airway disease.MethodsWe performed a retrospective review of a prospective database of patients who underwent robotic-assisted thoracoscopic tracheobronchoplasty between 2013 and 2020.ResultsA total of 118 patients underwent robotic-assisted thoracoscopic tracheobronchoplasty. Preoperative and postoperative pulmonary function tests were available for 108 patients. Postoperative pulmonary function tests at a median of 16 months demonstrated a significant increase in percent predicted forced expiratory volume in 1 second (preoperative median: 76.76% predicted, postoperative: 83% predicted, P = .002). Preoperative and postoperative St George Respiratory Questionnaires were available for 64 patients with a significant decrease in postoperative score at a median of 7 months (preoperative median: 61, postoperative: 41.60, P < .001). When stratified by preoperative degree of obstruction, robotic-assisted thoracoscopic tracheobronchoplasty improved forced expiratory volume in 1 second in moderate to very severe obstruction with a statistically significant improvement in moderate (preoperative median: 63.91% predicted, postoperative median: 73% predicted, P = .001) and severe (preoperative median: 44% predicted, postoperative median: 57% predicted, P = .007) obstruction. St George Respiratory Questionnaire scores improved for all patients. Improvement for mild (preoperative median: 61.27, postoperative median: 36.71, P < .001) and moderate (preoperative median: 57.15, postoperative median: 47.52, P = .03) obstruction was statistically significant.ConclusionsRobotic-assisted thoracoscopic tracheobronchoplasty improves obstruction and symptoms. With limited follow-up, subgroup analysis showed forced expiratory volume in 1 second improved in severe preoperative obstruction and quality of life improved in moderate obstruction. Future follow-up is required to determine robotic-assisted thoracoscopic tracheobronchoplasty effects on the most severe group, but we cannot conclude that increased degree of preoperative obstruction precludes surgery. |
