机器人辅助胸腔镜肺叶切除12例临床分析  

Clinical Analysis of 12 Patients Undergoing Robot-assisted Pulmonary Lobectomy

作　　者：罗清泉[1] 林皓[1] 黄佳[1] 许林[2] 

机构地区：[1]上海市胸科医院上海市肺部肿瘤临床医学中心,上海200030 [2]南京医科大学附属江苏省肿瘤医院胸外科,南京210009

出　　处：《中国胸心血管外科临床杂志》2014年第1期25-28,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探索应用daVinciS机器人辅助胸腔镜进行肺叶切除术的安全性、手术效果及在微创手术中的优势。方法2009年5月至2013年5月，上海市胸科医院应用daVinciS机器人辅助胸腔镜对12例临床拟诊为非小细胞肺癌（NSCLC）患者行肺叶切除术，男6例、女6例，年龄40～61（52±8）岁。所有手术通过1个12mm观察孔、2个8mm操作孔和1个12～40mm辅助切口完成，肋骨不撑开。收集分析患者同手术期资料。结果全组12例手术均获成功，包含所有位置肺叶切除，均系完全性切除，清扫淋巴结4～9（5±1）组，无中转开胸。所有患者均未发生围术期并发症或死亡。胸腔引流管引流时间3～11（8＋7）d，住院时间6～18（14＋8）d，手术时间60～280（185±78）min，术中出血量20～200（108±71）m1，围术期均未输血。结论机器人辅助胸腔镜肺叶切除术初步证明安全有效，电视胸腔镜有更逼真的视野、更灵活稳定的操作，从而具备更宽泛的手术适应证，是新一代微创胸部手术的重要选择。Objective To investigate the safety and efficacy of robot-assisted pulmonary lobectomy using da Vinci S System, and explore its advantages in minimally invasive surgery. Methods From May 2009 to May 2013, 12 pa- tients with suspected non-small cell lung cancer （NSCLC） underwent robot-assisted lobectomy using da Vinci S System in Shanghai Chest Hospital. There were 6 male and 6 female patients with their age of 40-61 （52 4-8 ）years. Robotic instru- ments were used through a 12-mm observation port, two 8-mm thoracoscopic ports and a 12 to 40 mm utility incision with- out rib spreading. Perioperative data of the patients were collected and analyzed. Results All the 12 patients successfully received surgical resection. All types of lobectomy were performed, and all the procedures were radical resection. Each patient received 4 to 9 （ 5 ±1 ） stations of lymph node dissection. None of the patients underwent conversion to thoracotomy. There was no perioperative mortality or morbidity in this group. Chest drainage duration was 3-11 （8 ± 7 ）days. Length of hospital stay was 6 to 18 （ 14 ± 8 ） days. Operation time was 60 to 280 （ 185 ± 78 ） minutes. Intraoperative blood loss was 20 to 200 （ 108 ± 71 ） ml. There was no perioperative blood transfusion. Conclusions Robot-assisted lobectomy is initially proven a safe and effective procedure with enhanced visualization and better dexterity and stability than video-assisted thoracopscopic surgery. Thus surgical indications for robot-assisted lobectomy can be widened, Robot-assisted lobectomy is an important choice in the new age of minimally invasive thoracic surgery.

关 键 词：机器人手术 肺叶切除术 微创胸外科 肺癌 

分 类 号：R655.3[医药卫生—外科学]