Comparison of Biportal Versus Multiportal Robotic Approaches for Pulmonary Resection in NSCLC (EC-UMUR)

September 7, 2026 updated by: Carlos Déniz

Clinical Trial in Patients With Non-Small Cell Lung Cancer Undergoing Biportal Versus Multiportal Robotic Thoracic Surgery: Comparison of Two Innovative Techniques

This study compares two established robotic surgical approaches for removing lung tumors in adults with non-small cell lung cancer: biportal robotic-assisted thoracic surgery (biRATS) and multiportal robotic-assisted thoracic surgery (multiRATS). Participants are assigned at random to one of the two approaches. The study will compare surgical safety, recovery after surgery, pain, length of hospital stay, quality of life, and other clinical outcomes during 12 months of follow-up.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Robotic-assisted thoracic surgery is widely used for pulmonary resection in patients with resectable non-small cell lung cancer. Multiportal RATS uses several access ports. Biportal RATS uses two access incisions and aims to preserve minimally invasive benefits while improving ergonomic access and instrument maneuverability.

This single-center, prospective, randomized, partially blinded clinical trial will compare biRATS with multiRATS in adults undergoing pulmonary resection with curative intent at Hospital Universitari de Bellvitge. Eligible participants who provide written informed consent will be randomly assigned using the study REDCap randomization system. A standardized dressing will be maintained for 48 hours after surgery to support partial blinding.

The main analysis will compare intraoperative and immediate postoperative complications between groups. Additional assessments include intraoperative blood loss, conversion, chest-drain duration, hospital length of stay, postoperative pain, readmission, mortality, and health-related quality of life. Quality of life will be assessed using EQ-5D-5L, EORTC QLQ-C30, and EORTC QLQ-LC13; pain will be measured with a visual analogue scale and DN4 questionnaire. Follow-up occurs during hospitalization and at 1, 6, and 12 months after surgery.

The planned sample is 70 to 80 participants (approximately 35 per group). The study is investigator initiated and has CEIm approval (PR208/24; protocol version 3.0 dated June 18, 2025).

Study Type

Interventional

Enrollment (Estimated)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Spain
    • Barcelona
      • L'Hospitalet de Llobregat, Barcelona, Spain, 08907
        • Recruiting
        • Hospital Universitari de Bellvitge
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 years or older, of any sex.
  • Non-small cell lung cancer considered clinically resectable, confirmed preoperatively or during surgery.
  • Candidate for pulmonary resection by robotic thoracic surgery.
  • Written informed consent.

Exclusion Criteria:

  • Declines participation or cannot provide written informed consent.
  • Thoracic anatomical abnormalities that preclude or materially affect robotic surgery.
  • Active thoracic infection.
  • Surgery not performed by a participating surgeon with comparable experience in biRATS and multiRATS.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: biRATS
Biportal robotic-assisted thoracic surgery for pulmonary resection using two access incisions.
Procedure: Biportal Robotic-Assisted Thoracic Surgery
Pulmonary resection performed with a biportal robotic-assisted thoracic surgery approach using two access incisions.
Active Comparator: multiRATS
Multiportal robotic-assisted thoracic surgery for pulmonary resection using multiple access ports.
Procedure: Multiportal Robotic-Assisted Thoracic Surgery
Pulmonary resection performed with a multiportal robotic-assisted thoracic surgery approach using multiple access ports.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of Intraoperative and Immediate Postoperative Complications
Time Frame: From surgery through hospital discharge, up to 30 days
Proportion of participants with intraoperative or immediate postoperative complications, classified by Clavien-Dindo grade. Events include, among others, prolonged air leak, pleuropulmonary infection, pneumothorax, postoperative hemorrhage, chylothorax, respiratory failure, wound infection, readmission, and perioperative death.
From surgery through hospital discharge, up to 30 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Intraoperative Blood Loss
Time Frame: During surgery
Estimated intraoperative blood loss in milliliters.
During surgery
Length of Hospital Stay
Time Frame: From surgery through hospital discharge, up to 30 days
Number of days from surgery to medical discharge.
From surgery through hospital discharge, up to 30 days
Postoperative Pain Intensity (Visual Analog Scale)
Time Frame: From baseline through 12 months after surgery
Pain intensity measured using the Visual Analog Scale (VAS), a 0 to 10 scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain.
From baseline through 12 months after surgery
Neuropathic Pain (Douleur Neuropathique 4 Questionnaire)
Time Frame: From baseline through 12 months after surgery
Neuropathic pain assessed using the Douleur Neuropathique 4 (DN4) questionnaire, scored from 0 to 10. Scores of 4 or higher are consistent with neuropathic pain; higher scores indicate a greater likelihood of neuropathic pain.
From baseline through 12 months after surgery
Health Status (EuroQol 5-Dimension 5-Level Questionnaire)
Time Frame: From baseline through 12 months after surgery
Health status assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) descriptive system. Five dimensions are each rated from 1 (no problems) to 5 (extreme problems); lower levels indicate better health status.
From baseline through 12 months after surgery
Global Health Status/Quality of Life (EORTC QLQ-C30)
Time Frame: From baseline through 12 months after surgery
Global health status/quality of life assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status/QoL scale, transformed to a 0 to 100 score; higher scores indicate better global health status/quality of life.
From baseline through 12 months after surgery
Patient-Reported Lung Cancer Symptoms (EORTC QLQ-LC13)
Time Frame: From baseline through 12 months after surgery
Lung cancer-related symptoms assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13). Symptom scores are transformed to 0 to 100; higher scores indicate greater symptom burden.
From baseline through 12 months after surgery
Postoperative Healthcare Procedures
Time Frame: From surgery through hospital discharge, up to 30 days
Number of additional medical procedures required during the index hospitalization, including chest-drain management interventions.
From surgery through hospital discharge, up to 30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Carlos Déniz

Investigators

  • Principal Investigator: Carlos Déniz Armengol, MD, PhD, Hospital Universitari de Bellvitge

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 15, 2026

Primary Completion (Estimated)

February 1, 2028

Study Completion (Estimated)

February 1, 2028

Study Registration Dates

First Submitted

September 1, 2026

First Submitted That Met QC Criteria

September 7, 2026

First Posted (Actual)

September 14, 2026

Study Record Updates

Last Update Posted (Actual)

September 14, 2026

Last Update Submitted That Met QC Criteria

September 7, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HUB-CTO-2024-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because of data-protection and institutional-governance requirements.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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