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This trial showed that video assisted thoracoscopic lobectomy was associated with better physical function at five weeks and improved quality of life, while producing a cost saving.

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Eric Lim 1,*, Rosie A Harris 2, Holly E McKeon 2, Timothy JP Batchelor 3, Joel Dunning 4, Michael Shackcloth 5, Vladimir Anikin 1, Babu Naidu 6, Elizabeth Belcher 7, Mahmoud Loubani 8, Vipin Zamvar 9, Lucy Dabner 2, Timothy Brush 2, Elizabeth A Stokes 10,11, Sarah Wordsworth 10,11, Sangeetha Paramasivan 12, Alba Realpe 12, Daisy Elliott 13, Jane Blazeby 13, Chris A Rogers 2

1 Academic Division of Thoracic Surgery, The Royal Brompton and Harefield Hospitals, London, UK
2 Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
3 Thoracic Surgery, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
4 Department of Cardiothoracic Surgery, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
5 Department of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK
6 Department of Thoracic Surgery, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
7 Cardiothoracic Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
8 Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
9 Department of Cardiothoracic Surgery, Edinburgh Royal Infirmary, Edinburgh, UK
10 Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
11 National Institute for Health and Care Research Oxford Biomedical Research Centre, Oxford, UK
12 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
13 National Institute for Health and Care Research Bristol and Weston Biomedical Research Centre, Surgical Innovation Theme, Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK
* Corresponding author Email: e.lim@rbht.nhs.uk

Declared competing interests of authors: Eric Lim reports personal fees from Abbott Molecular (Abbott Park, IL, USA), GlaxoSmithKline plc (Brentford, UK), Pfizer Inc. (New York, NY, USA), Novartis Pharmaceuticals UK Ltd (London, UK), Medtronic plc/Covidien (Dublin, Ireland), Roche Diagnostics (Hertford, UK), Lilly Oncology (Indianapolis, IN, USA), Boehringer Ingelheim (Bracknell, UK), Medela (Baar, Switzerland), Johnson & Johnson/Ethicon (New Brunswick, NJ, USA), AstraZeneca (Cambridge, UK) and Bristol-Myers Squibb (New York, NY, USA); grants from Clearbridge BioMedics (Singapore Science Park, Singapore), Illumina (San Diego, CA, USA) and Guardant Health (Redwood City, CA, USA); and grants and personal fees from ScreenCell (Sarcelles, France) outside the submitted work. In addition, Eric Lim has patents P52435GB and P57988GB issued to Imperial Innovations (London, UK). Lastly, Eric Lim is chief investigator for a National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) report (reference 15/188/31). Chris Rogers reports membership of the NIHR HTA Research Commissioning Committee (2016–21) and the NIHR HTA Policy Committee (2017–21). Timothy Batchelor reports personal fees from Johnson & Johnson, Medtronic plc, Medela and AstraZeneca outside the submitted work. Joel Dunning reports personal fees from Cambridge Medical Robotics (Cambridge, UK), ArtiSential (San Diego, CA, USA) and Medtronic plc/Covidien outside the submitted work. Jane Blazeby reports membership of the HTA Obesity Themed Call Board (2010), the HTA Surgery Themed Call Board (2012–13), the NIHR Clinical Trials Unit Standing Advisory Committee (2012–20) and the HTA Clinical Evaluation and Trials Committee (2009–13).

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