南通大学附属医院胸外科于 2023 年 5 月收治 1 例肺结节患者,应用术前三维软件,选择达芬奇机器 人 Xi 手术系统,开展机器人辅助单孔胸腔镜右下肺联合亚段(S6b+S8a)切除术,最大限度的切除肿瘤组织并保留 了健康肺组织。手术顺利,手术时长 164 min,术中出血约 10 ml,患者术后无并发症发生,顺利出院。随访至今, 未发生复发及转移。
In May 2023, a patient was admitted to the Affiliated Hospital of Nantong University due to pulmonary nodule. In this case, combined subsegmental (S6b+S8a) resection of the right lower lung was performed using the preoperative 3D software and Da Vinci Xi surgical system to resect tumor tissue and preserve healthy lung tissue maximally. The operation went well, with the operative time of 164 min and the intraoperative blood loss of 10 ml approximately. The patient was successfully discharged without complications. No recurrence or metastasis was observed in follow-up to now.
收稿日期:2023-09-11 录用日期:2023-11-23
Received Date: 2023-09-11 Accepted Date: 2023-11-23
基金项目:南通市卫生健康委科研课题项目(MB2021007)
Foundation Item: Scientific Research Project of Nantong Municipal Health Commission (MB2021007)
通讯作者:陈建乐,Email:jsshcjl@163.com
Corresponding Author: CHEN Jianle, Email: jsshcjl@163.com
引用格式:徐明明,朱俊,杨学超,等 . 机器人辅助单孔胸腔镜肺联合亚段切除术:全球首例报道(附视频)[J]. 机器人外科学杂 志(中英文),2024,5(2):227-232.
Citation: XU M M, ZHU J, YANG X C, et al. Uniportal robot-assisted thoracoscopic surgery for combined subsegmentectomy : the first case report (with video)[J]. Chinese Journal of Robotic Surgery, 2024, 5(2): 227-232.
[1] Siegel R L, Miller K D, Fuchs H E, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72(1): 7-33.
[2] Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, openlabel, phase 3, randomised, controlled, non-inferiority trial[J]. Lancet, 2022, 399(10335): 1607-1617.
[3] Altorki N, Wang X, Kozono D, et al. Lobar or sublobar resection for peripheral stage IA non-small-cell lung cancer[J]. N Engl J Med, 2023, 388(6): 489-498.
[4] WU W B, XIA Y, PAN X L, et al. Three-dimensional navigation - guided thoracoscopic combined subsegmentectomy for intersegmental pulmonary nodules[J]. Thorac Cancer, 2019, 10(1): 41-46.
[5] Mangiameli G, Cioffi U, Testori A. Lung cancer treatment: from tradition to innovation[J]. Front Oncol, 2022, 12: 858242. DOI: 10.3389/fonc.2022.858242.
[6] GUO F, MA D J, LI S Q. Compare the prognosis of Da Vinci robot-assisted thoracic surgery (RATS) with videoassisted thoracic surgery (VATS) for non-small cell lung cancer: a meta-analysis[J]. Medicine (Baltimore), 2019, 98(39): e17089.
[7] Raman V, Jawitz O K, Voigt S L, et al. The effect of tumor size and histologic findings on outcomes after segmentectomy vs lobectomy for clinically nodenegative non-small cell lung cancer[J]. Chest, 2021, 159(1): 390-400.
[8] Kim Y W, Lee C T. Optimal management of pulmonary ground-glass opacity nodules[J]. Transl Lung Cancer Res, 2019, 8(Suppl 4): S418-S424.
[9] LV F, WANG B, XUE Q, et al. Lobectomy vs. sublobectomy for stage I non-small-cell lung cancer: a meta-analysis[J]. Ann Transl Med, 2021, 9(9): 751.
[10] Yoshimoto K, Nomori H, Mori T, et al. Combined subsegmentectomy: postoperative pulmonary function compared to multiple segmental resection[J]. J Cardiothorac Surg, 2011, 6: 17. DOI: 10.1186/1749- 8090-6-17.
[11] Horinouchi H, Nomori H, Nakayama T, et al. How many pathological T1N0M0 non-small cell lung cancers can be completely resected in one segment? Special reference to high-resolution computed tomography findings[J]. Surg Today, 2011, 41(8): 1062-1066.
[12] Cannella M, Cornelis F, Descat E, et al. Bronchopleural fistula after radiofrequency ablation of lung tumours[J]. Cardiovasc Intervent Radiol, 2011, 34(Suppl 2): S171-S174.
[13] Motas N, Manolache V, Bosinceanu M L, et al. Uniportal robotic-assisted thoracic surgery anatomic segmentectomies[J]. Ann Cardiothorac Surg, 2023, 12(2): 133-135.
[14] YANG S, GUO W, CHEN X S, 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.
[15] Davini F, Ricciardi S, Zirafa C C, et al. Treatment of pulmonary nodule: from VATS to RATS[J]. J Vis Surg, 2018, 4(2): 36.
[16] ZHANG J Y, FENG Q B, HUANG Y R, et al. Updated evaluation of robotic- and video-assisted thoracoscopic lobectomy or segmentectomy for lung cancer: a systematic review and meta-analysis[J]. Front Oncol, 2022, 12: 853530. DOI: 10.3389/fonc.2022.853530.
[17] Gonzalez-Rivas D, Bosinceanu M, Manolache V, et al. Uniportal fully robotic-assisted bronchovascular sleeve bilobectomy[J]. Ann Cardiothorac Surg, 2023, 12(2): 144-146.
[18] Motas N, Gonzalez-Rivas D, Bosinceanu M L, et al. Uniportal robotic-assisted thoracic surgery pneumonectomy[J]. Ann Cardiothorac Surg, 2023, 12(1): 67-69.
[19] SUN Y G, ZHANG Q, WANG Z, et al. Feasibility investigation of near-infrared fluorescence imaging with intravenous indocyanine green method in uniport videoassisted thoracoscopic anatomical segmentectomy for identifying the intersegmental boundary line[J]. Thorac Cancer, 2021, 12(9): 1407-1414.
[20] Wu C F, Cheng C, Suen K H, et al. A preclinical feasibility study of single-port robotic subcostal anatomical lung resection and subxiphoid thymectomy using the da Vinci® SP system[J]. Diagnostics (Basel), 2023, 13(3): 460.
[21] 吴禹池 , 许世广 , 徐惟 , 等 . 达芬奇机器人辅助肺 叶和肺段切除术治疗ⅠA 期非小细胞肺癌疗效的 回顾性队列研究 [J]. 中国胸心血管外科临床杂志 , 2023, 30(1): 7.