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Ricciardi et al. Mini-invasive Surg 2020;4:1 I http://dx.doi.org/10.20517/2574-1225.2019.50 Page 3 of 8

Figure 1. We present graphically our searching strategy. RCT: randomized control trial

Mid- and long-term outcomes
The mid- and long-term outcomes of 2850 patients were analysed, with a survival time analysis ranging
between two years and five years. Seven studies showed the survival of patients who underwent robotic
surgery in a single centre with a follow-up ranging between 13.3 and 40.3 months. The studies were
inhomogeneous for survival time analysis (two-, three- or five-year results) and patients’ stage (only stage I
analysis or multiple stage data) [Table 2].

[6]
Toosi et al. analysed 249 patients who underwent robotic lobectomy and showed a mean operative-time,
conversion rate and rates of perioperative outcomes comparable to those of VATS and open surgery. The
primary endpoint of this study was the evaluation of the effectiveness of lymphadenectomy (LN) by robotic
approach and the authors revealed that LN staging with robotic surgery was comparable to or better
than that obtained with conventional VATS and open approach. Moreover, the authors showed an overall
survival (OS) comparable with that described in the literature, but the survival analysis was limited by the
short mean follow-up time (18 months).

[7]
The aim of the study published by Yang et al. was to compare the long-term outcomes [OS and disease-
free survival (DFS)] of three cohorts (robotic, VATS and open) of clinical stage I NSCLC patients matched
by propensity score. The authors stated that MIS lobectomy for clinical stage I NSCLC guarantees
comparable long-term survival as thoracotomy and was associated with shorter hospitalisation. The five-
year OS and DFS for the robotic group were 77.6% and 72.7%, respectively, and 13.5% (25/184) patients
experimented recurrences.