目的：对比研究达芬奇机器人与胸腔镜下肺段切除术患者的围手术期数据，评价机器人肺段切除术的临床价值。方法：回顾性分析 2018 年 12 月 -2020 年 2 月在郑州大学第一附属医院胸外科行机器人肺段切除术 68例患者(机器人组)和胸腔镜下肺段切除术 49 例患者(胸腔镜组)的临床资料。比较两组患者肺段切除类型、术后疼痛评分、住院费用、手术时间、术中失血蜇、清扫淋巴结组数及个数、术后住院时间、胸腔引流管留置时间、引流总蜇以及术后并发症发生情况，从而明确两种手术方式的有效性差异。结果：机器人组比胸腔镜组术后疼痛评分更低 [(1.94士0.64)分 Vs(2.29士0.65)分，P<0.05]；N1 淋巴结清扫的组数 [1(1-2)组Vs 2(1-3)组，P=0.002]和数蜇 [2(1-3)枚 Vs 3(1-4)枚，P=0.014] 有差异，机器人组优千胸腔镜组；住院费用为 80 815.00(47 914.79-113 023.66)元和 98 213.41(65 302.90-155 561.88)元，机器人组高千胸腔镜组(P<0.05)。结论：机器人和胸腔镜肺段切除术对非小细胞肺癌的早期治疗是安全可行的，而机器人肺段切除术可能有更好的 N1 淋巴结清扫效果。

Objective: To evaluate the clinical value of robot-assisted segmentectomy by comparing the perioperative data of patients underwent Da Vinci robot-assisted and thoracoscopic segmentectomy. Methods: Clinical data of 68 patients who underwent robot-assisted segmentectomy (robotic group) and 49 patients who underwent thoracoscopic segmentectomy (thoracoscopy group) at the Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University from December 2018 to February 2020 were retrospectively analyzed. The types of lung segmentectomy, postoperative pain score, hospitalization costs, operative time, intraoperative blood loss, number and groups of lymph node dissection, postoperative hospitalization time, retention time of chest drainage tube, total drainage volume and postoperative complications of the two groups were compared to determine the different clinical effectiveness of the two approaches. Results: The robotic group showed lower postoperative pain scores than the thoracoscopy group [(1.94士0.64) Vs (2.29士0.65), P<0.05]. The N1 lymph nodes dissection were different on groups [1 (IQR 1 to 2) Vs 2 (IQR 1 to 3), P=0.002] and amount [2 (IQR 1 to 3) Vs 3 (IQR 1 to 4), P=0.014] and the robotic group was superior to the thoracoscopy group, but the hospitalization cost of robotic group was higher than that in the thoracoscopy group [80 815.00 (47 914.79 to 113 023.66) CNY Vs 98 213.41 (65 302.90 to 155 561.88) CNY, P<0.05]. Conclusion: Robot-assisted and thoracoscopic segmentectomy are safe and feasible in treating early-stage non-small cell lung cancer. Robotic approach may lead to a better N1 lymph node dissection.

收 稿 日 期 ：2020-04-16 录 用 日 期 ：2020-08-03 Received Date: 2020-04-16 Accepted Date: 2020-08-03

基金项目：河南省医学科技攻关计划联合共建项目(LHG20190301)

Foundation Item: The Joint Construction Project of Henan Medical Science and Technology Project, China (LHG20190301)

通 讯 作 者 ： 齐 宇 ，Email 仆 ekans@126.com Corresponding Author: QI Yu, Email:ekans@126.com

引用格式：叶贯超，刘亚飞，张春歇，等 . 达芬奇机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌的有效性对比 [J]. 机器人外科学杂志，2021，2(1)仆1-9.

Citation: YE G C, LIU Y F, ZHANG C Y, et al. A comparative study on effectiveness of Da Vinci robot-assisted and thoracoscopic segmentectomy in the treatment of early-stage non-small cell lung cancer [J]. Chinese Journal of Robotic Surgery, 2021, 2(1): 1-9.

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