摘要
目的比较机器人辅助胸腔镜(robotic-assisted thoracoscopic surgery,RATS)与电视辅助胸腔镜(video-assisted thoracoscopic surgery,VATS)非典型肺段切除术治疗早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的围术期结果。方法回顾性分析2016年10月—2021年12月间陆军军医大学大坪医院胸外科行微创解剖性非典型肺段切除术患者的临床资料。根据手术方式将患者分为RATS组和VATS组。采用倾向性评分匹配法选择临床基线特征邻近的患者,比较两组患者的围术期结果。结果纳入患者1048例,其中男320例、女728例,平均年龄(53.51±11.13)岁。RATS组277例,VATS组771例。倾向性评分匹配后,最终选择277对病例。两组患者的年龄、性别、吸烟史、体重指数、合并症指数、肺功能、肿瘤大小、肿瘤位置以及组织学类型差异无统计学意义(P>0.05)。两组所有病例均实现R0切除,无术后30 d内死亡。RATS组和VATS组的手术时间[85(75,105)min vs.115(95,140)min,P<0.001]、术中出血量[50(30,100)mL vs.60(50,100)mL,P=0.001]差异具有统计学意义。两组患者在淋巴结切除个数、中转开胸率、胸腔引流时间、胸腔引流液总量、术后并发症发生率方面差异均无统计学意义(P>0.05)。结论RATS与VATS非典型肺段切除术治疗早期NSCLC均安全可行。RATS能有效缩短手术时间,减少术中出血量。
Objective To compare the perioperative outcomes of atypical segmentectomy between roboticassisted thoracoscopic surgery(RATS)and conventional video-assisted thoracoscopic surgery(VATS)in early-stage nonsmall cell lung cancer(NSCLC).Methods The data of patients who underwent minimally invasive anatomic atypical segmentectomy in our hospital from October 2016 to December 2021 were collected.These patients were divided into a RATS group and a VATS group according to the operation method.Propensity score(PS)matching was used to select patients with close clinical baseline characteristics,and the perioperative results of the two groups were compared.Results A total of 1048 patients were enrolled,including 320 males and 728 females,with a mean age of 53.51±11.13 years.There were 277 patients in the RATS group and 771 patients in the VATS group.After 1∶1 PS matching,277 pairs were selected.Both groups were well balanced for age,sex,smoking history,body mass index,Charlson comorbidity index,pulmonary function,tumor size,tumor location,and histological type.All patients were R0 resection,and there were no deaths within 30 days after surgery.The RATS group had shorter operative time[85(75,105)min vs.115(95,140)min,P<0.001]and less blood loss[50(30,100)mL vs.60(50,100)mL,P=0.001].There were no statistical differences between the two groups in lymph node resection,conversion to thoracotomy,thoracic drainage time,total amount of thoracic drainage or postoperative complications(P>0.05).Conclusion Both RATS and VATS atypical segmentectomies are safe and feasible for early-stage NSCLC.RATS can effectively shorten the operative time,and reduce blood loss.
作者
戴富强
陶绍霖
吴晓丽
王昕田
梅龙勇
邓波
谭群友
DAI Fuqiang;TAO Shaolin;WU Xiaoli;WANG Xintian;MEI Longyong;DENG Bo;TAN Qunyou(Department of Thoracic Surgery,Daping Hospital,Army Medical University,Chongqing,400042,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2023年第4期557-563,共7页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
重庆市技术创新与应用发展项目(cstc2019jscx-msxmX0252)。
关键词
机器人辅助胸腔镜手术
电视辅助胸腔镜手术
非小细胞肺癌
非典型肺段切除术
围术期结果
Robotic-assisted thoracoscopic surgery
video-assisted thoracoscopic surgery
non-small cell lung cancer
atypical segmentectomy
perioperative results
