达芬奇机器人与胸腔镜在肺癌淋巴结整块清扫中的对比研究

摘要/Abstract

评价机器人辅助胸腔手术（Robot-assisted thoracic surgery，RATS）与传统胸腔镜手术（Video-assisted thoracic surgery，VATS）在肺癌淋巴结整块清扫中的临床疗效。方法：回顾性分析 2017 年 5 月 ~2019 年 12 月在甘肃省人民医院接受达芬奇机器人和胸腔镜进行淋巴结整块清扫手术的 128 例肺癌患者的临床资料，分别为 RATS 组与 VATS 组，其中接受 RATS 的患者 56 例，VATS 72 例。结果：RATS 组与 VATS 组相比，手术时间（171.31min Vs154.26min，P=0.026）、术中失血量（62.29ml Vs 92.73ml，P=0.031）、术后引流时间（5.72d Vs 7.13d，P=0.043）、总引流量（1 105.76ml Vs 1 434.62ml，P=0.017）、术后住院时间（7.25d Vs 9.36d，P=0.003）、淋巴结清扫总数（17.38 个 Vs 12.93 个，P=0.045）比较，差异具有统计学意义。而两组术后并发症比较，差异没有统计学意义（P>0.05）。但 RATS 组在进行左肺上叶手术时以及清扫 2、4、7 组淋巴结时比 VATS 组更具有显著优势，差异有统计学意义（P<0.05）。结论：机器人系统在肺癌根治术淋巴结清扫中，操作安全、创伤小，且在清扫胸部淋巴结时更加有效，更利于患者的术后恢复，能减少复发及转移的可能性，使患者切实获益。

To evaluate the clinical efficacy of robot-assisted thoracic surgery (RATS) and traditional thoracoscopic surgery (VATS) in lung cancer lymph node dissection. Methods: 128 patients with lung cancer who underwent whole lymph node dissection by Da Vinci robot and thoracoscopy in our hospital from May 2017 to December 2019 were selected, 56 patients received RATS and 72 patients received VATS. The clinical data was analyzed with SPSS22.0 software. Results: RATS group Vs VATS group, surgery time (171.31min Vs 154.26min; P=0.026), intraoperative blood loss (62.29ml Vs 92.73ml, P=0.031), postoperative drainage time (5.72d Vs 7.13d, P=0.043), total drainage volume (1105.76ml Vs 1434.62ml, P=0.017), postoperative hospital stay (7.25d Vs 9.36d, P=0.003), total lymph node dissection (17.38 Vs 12.93, P=0.045), the difference was statistically significant.There was no significant difference between the two groups on postoperative complications (P>0.05). However, the RATS group had a significant advantage over the VATS group in the operation on the upper lobe of left lung and the dissection of 2, 4 and 7 groups of lymph node (P<0.05). Conclusion: The robot system is safe and effective in lymph node dissection of lung cancer.It is more effective and conducive to the postoperative recovery of patients in chest lymph node dissection, which also could lower the possibility of recurrence and metastasis.

稿件信息

参考文献

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