Semi‐Continuous Versus Continuous Suturing Techniques in Bronchial Anastomosis Following da Vinci Robotic‐Assisted Sleeve Lobectomy

BACKGROUND: In robot-assisted thoracoscopic (RATS) bronchial sleeve lobectomy, despite the continuous suturing (CS) technique's widespread adoption, the safety and advantages of the semi-continuous suturing (SCS) technique remain inconclusive. METHODS: Patients undergoing RATS bronchial sleeve lobectomy for central Non-Small Cell Lung Cancer (NSCLC) between January 2020 and December 2024 were retrospectively enrolled and stratified into two cohorts based on anastomotic technique: the CS group and the SCS group. Perioperative outcomes were compared between the two groups. RESULTS: The SCS group (n = 18) demonstrated significantly shorter anastomotic time than the CS group (n = 14) (median 28 min [24-33] vs. 45 min [32-52]; p < 0.001), with a 21-min reduction in operative time (median 135 min [110-185] vs. 156 min [138-212]; p = 0.040). No statistically significant differences were observed in: overall complication rates (anastomosis-specific: 11.1% vs. 21.4%, p = 0.425; systemic: 22.2% vs. 42.9%, p = 0.212); 90-day mortality (0% vs. 7.1%, p = 0.467); late stenosis rate (0% vs. 7.1%, p = 0.249) or reoperation rate (5.6% vs. 14.3%, p = 0.401); postoperative recovery metrics (extubation time and hospital stay, p > 0.05). CONCLUSIONS: SCS can safely reduce bronchial anastomosis time in RATS sleeve resection and is recommended as the preferred technique for optimizing operative efficiency.