摘要
目的探讨全孔机器人与胸腔镜肺叶切除术在ⅠA期非小细胞肺癌中的围手术期疗效与安全性。方法回顾性分析2019年6月—2022年6月哈尔滨医科大学附属第二医院胸外科同一术者开展的ⅠA期非小细胞肺癌肺叶切除并淋巴结清扫术患者的临床资料。依据术式不同分为机器人组和胸腔镜组。比较两组患者手术时间、术中出血量、淋巴结清扫站数和个数、术后带管时间、术后住院时间、胸腔闭式引流量、术后疼痛、术后并发症及住院费用等相关指标。结果机器人组共83例,其中男34例、女49例,中位年龄60.0(53.0,67.0)岁;胸腔镜组94例,其中男36例、女58例,中位年龄60.5(54.0,65.3)岁。两组患者均无中转开胸及术后90 d死亡病例。两组手术时间、术后总引流量及术后并发症发生率等差异无统计学意义(P>0.05)。机器人组患者术中出血量较少(P<0.001),淋巴结清扫站数(P=0.002)及个数(P=0.005)较多,患者术后疼痛更轻(P=0.002),术后带管时间(P=0.031)和住院时间(P<0.001)明显缩短,但机器人组手术费用较高(P<0.001)。结论全孔机器人相较于胸腔镜肺叶切除术,术中出血量更少、淋巴结清扫更彻底、术后疼痛感更轻、住院时间更短,对于早期非小细胞肺癌患者来说是安全有效的。
Objective To investigate the perioperative efficacy and safety of all-port robotic lobectomy versus thoracoscopic lobectomy in stageⅠA non-small cell lung cancer.Methods The clinical data of patients with stageⅠA non-small cell lung cancer who underwent lobectomy with lymph node dissection performed by the same operator in our center from June 2019 to June 2022 were retrospectively analyzed.The patients were divided into a robotic group and a thoracoscopic group according to different procedures.We compared the relevant indexes such as operation time,intraoperative bleeding,number of lymph node dissection stations,number of lymph node dissection,postoperative tube time,postoperative hospitalization time,closed chest drainage volume,postoperative pain,postoperative complications and hospitalization cost between the two groups.Results There were 83 patients in the robotic group,including 34 males and 49 females with a median age of 60.0(53.0,67.0)years,and 94 patients in the thoracoscopic group,including 36 males and 58 females with a median age of 60.5(54.0,65.3)years.There was no conversion to thoractomy or death in postoperative 90 days in both groups.No statistical difference was seen in the operation time,total postoperative drainage volume and postoperative complication rates between the two groups(P>0.05).Patients in the robotic group had less intraoperative bleeding(P<0.001),more lymph node dissection stations(P=0.002)and numbers(P=0.005),less postoperative pain(P=0.002),and shorter postoperative time with tubes(P=0.031)and hospital stay(P<0.001).However,the surgery was more expensive in the robotic group(P<0.001).Conclusion All-port robotic surgery is safe and effective for patients with early-stage non-small cell lung cancer with less intraoperative bleeding,more lymph node dissection,less postoperative pain,and shorter hospital stay compared with the thoracoscopic surgery.
作者
姚灵琦
常啸岩
沈志平
王开宇
李毅
徐昊
张临友
YAO Lingqi;CHANG Xiaoyan;SHEN Zhiping;WANG Kaiyu;LI Yi;XU Hao;ZHANG Linyou(Department of Thoracic Surgery,The Second Affiliated Hospital of Harbin Medical University,Harbin,150086,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10期1390-1395,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
