随着微创理念与技术的发展，达芬奇机器人在外科领域的应用越来越普遍。2009年中国第1例达芬奇机器人胸外科手术开始，至今已有12年。目前，在胸外科常见的肺癌、食管癌、纵隔肿物等手术治疗方面，达芬奇机器人手术的独特优势逐渐凸显出来。本文主要对达芬奇机器人在胸外科手术中的应用、优缺点进行阐述，同时对达芬奇机器人的未来发展进行展望。

With the development of minimally invasive technologies, Da Vinci robotic surgery is becoming more and more common in the field of surgery. The first Da Vinci robotic thoracic surgery of China was performed in 2009, and it has been 12 years now. At present, unique advantages of Da Vinci robotic surgery in treating common lung cancer, esophageal cancer and mediastinal masses in thoracic surgery have been highlighted. In this article, the application, advantages and disadvantages of Da Vinci robotic surgical system in thoracic surgery was discussed, and the future development of Da Vinci robot was prospected.

收稿日期：2021-09-09 录用日期：2021-11-25

Received Date: 2021-09-09 Accepted Date: 2021-11-25

基金项目：解放军总医院临床扶持基金（2014FC-ZHCG-107）

Foundation Item: Clinical Supporting Fundation of PLA General Hospital (2014FC-ZHCG-107)

通讯作者：夏晖，Email：xiah304@163.com

Corresponding Author: XIA Hui, Email: xiah304@163.com

引用格式：方学森，李少军，陈平，等. 机器人手术在胸外科中的应用进展[J]. 机器人外科学杂志（中英文），2022，3（3）：235-239.

Citation: FANG X S, LI S J, CHEN P, et al. Application progress of surgical robot in thoracic surgery[J]. Chinese Journal of Robotic Surgery, 2022, 3 (3): 235-239.

[1] Leal Ghezzi T, Campos Corleta O. 30 years of robotic surgery[J]. World Journal of Surgery, 2016, 40(10):2550-2557.

[2] 王刚, 潘华峰, 刘江, 等. 达芬奇Xi 系统在完全机器人根治性远端胃大部切除术中的应用[J]. 山东大学学报( 医学版), 2020, 58(5): 51-55.

[3] 张琥, 曾昭宇, 程弓, 等. 达芬奇手术机器人从引进到使用过程中的科学管理[J]. 北京生物医学工程,2021, 40(1): 101-104.

[4] LI J T, LIU P Y, HUANG J, et al. Perioperative outcomes of radical lobectomies using robotic-assisted thoracoscopic technique vs. video-assisted thoracoscopic technique: retrospective study of 1, 075 consecutive p-stage I non-small cell lung cancer cases[J]. Journal of

Thoracic Disease, 2019, 11(3): 882-891.

[5] Siegel R L, Miller K D, Jemal A. Cancer statistics,2020[J]. CA: A Cancer Journal for Clinicians, 2020,70(1): 7-30.

[6] Terra R M, Bibas B J, Haddad R, et al. Robotic thoracic surgery for non-small cell lung cancer: initial experience in Brazil[J].J Bras Pneumol, 2019, 46(1): e20190003.

[7] ZHOU Q, HUANG J, PAN F, et al. Operative outcomes and long-term survival of robotic-assisted segmentectomy for stage IA lung cancer compared with video-assisted thoracoscopic segmentectomy[J]. Transl Lung Cancer Res, 2020, 9(2): 306-315.

[8] CHENG X H, LI C W, HUANG J, et al. Threearm robot-assisted thoracoscopic surgery for locally advanced N2 non-small cell lung cancer[J]. Journal of Thoracic Disease, 2018, 10(12) : 7009-7013.

[9] LIU X, XU S, LIU B, et al. Survival analysis of stage I non-small cell lung cancer patients treated with Da Vinci robot-assisted thoracic surgery[J]. Chinese Journal of Lung Cancer, 2018, 21(11): 849-856.

[10] YANG S, GUO W, CHEN X, et al. Early outcomes of robotic versus uniportal video-assisted thoracic surgery for lung cancer: a propensity score-matched study [J]. Eur J Cardiothorac Surg, 2018, 53(2):348-352.

[11] 林杰. 基于倾向性评分匹配法的机器人与胸腔镜辅助肺叶切除术对早期非小细胞肺癌的近期和远期疗效比较[D]. 大连医科大学, 2019.

[12] 蒋彬, 康珀铭, 陶绍霖, 等. 机器人与胸腔镜手术治疗前纵隔肿物的近期疗效对比[J]. 第三军医大学学报, 2019, 41(16): 1578-1582.

[13] 杨煜, 章雪飞, 茅腾, 等. 达芬奇机器人辅助纵隔肿瘤切除术339 例近期疗效分析: 一项单中心回顾性病例对照研究[J]. 中华胸心血管外科杂志, 2020,

36(11): 660-663.

[14] CHEN K, ZHANG X, JIN R, et al. Robot-assisted thoracoscopic surgery for mediastinal masses: a singleinstitution

experience[J]. J Thorac Dis, 2020, 12(2):105-113.

[15] Leow O Q Y, Cheng C, Chao Y K. Trans-subxiphoid robotic surgery for anterior mediastinal disease: an initial case series[J]. J Thorac Dis, 2020, 12(2): 82-88.

[16] Malhotra G K, Yanala U, Ravipati A, et al. Global trends in esophageal cancer[J]. J Surg Oncol, 2017,115(5): 564-579.

[17] Collard J M. Role of videoassisted surgery in the treatment of oesophageal cancer[J]. Ann Chir Gynaecol,1995, 84(2): 209-214.

[18] Kernstine K H, DeArmond D T, Karimi M, et al. The robotic, 2-stage, 3-field esophagolymphadenectomy[J].J Thorac Cardiovasc Surg, 2004, 127(6) : 1847-1849.

[19] de la Fuente S G, Weber J, Hoffe S E, et al. Initial experience from a large referral center with roboticassisted Ivor Lewis esophagogastrectomy for oncologic purposes[J]. Surg Endosc, 2013, 27( 9) : 3339-3347.

[20] 李刚, 沈旭, 阿来古哈, 等. 达芬奇机器人辅助食管癌切除术与胸腹腔镜联合食管癌切除术临床效果比较的系统评价与Meta 分析[J/OL]. 中国胸心血管外科临床杂志, 2021. DOI: 10.7507/1007-4848.202009098.

[21] 段晓峰, 岳杰, 陈传贵, 等. 机器人辅助McKeown食管癌切除术近期疗效分析[J]. 机器人外科学杂志( 中英文), 2020, 1(5): 355-363.

[22] XU Y, LI X K, CONG Z Z, et al. Long-term outcomes of robotic-assisted versus thoraco-laparoscopic McKeown esophagectomy for esophageal cancer: a propensity score-matched study [J]. Dis Esophagus, 2020. DOI:10.1093/dote/doaa114.