达芬奇机器人非小细胞肺癌手术疗效分析  

The therapeutic effect of non-small cell lung cancer with da Vinci surgical( robot-assisted thoracic surgery) system

作　　者：刘星池[1] 许世广[1] 徐惟[1] 刘博[1] 王通[1] 李博[1] 王希龙[1] 滕洪[1] 王述民[1] 莫奇峰[2] 孟庆雨[2] 

机构地区：[1]沈阳军区总医院胸外科,110016 [2]南京医科大学第二附属医院心胸外科,210011

出　　处：《中华腔镜外科杂志（电子版）》2017年第2期97-101,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨应用达芬奇机器人行非小细胞肺癌根治术的治疗效果。方法回顾性分析2012年1月至2015年1月于沈阳军区总医院胸外科治疗的202例非小细胞肺癌患者资料,其中80例患者(机器人组)行达芬奇机器人肺叶切除、淋巴结清扫术,122例患者(胸腔镜组)行胸腔镜肺叶切除、淋巴结清扫术。比较两组的淋巴结清扫情况及术后治疗效果。结果机器人组和胸腔镜组的淋巴结清扫数[(16.93±8.00)枚vs(13.98±8.67)枚]及淋巴结清扫组数[(4.89±1.57)组vs(4.25±1.23)组]、术后2年无进展生存率(71.2%vs 57.4%),Ⅰ期淋巴结清扫数[(16.59±8.57)枚vs(11.86±6.61)枚]、术后2年无进展生存率(84.3%vs 57.8%)及生存率(96.1%vs84.4%)比较,机器人组均优于胸腔镜组(P<0.05);机器人组和胸腔镜组的术中出血量[(57±49)ml vs(211±180)ml]及术后引流量[术后1 d为(255±116)ml vs(332±175)ml、术后2 d为(259±114)ml vs(321±172)ml]比较,机器人组均少于胸腔镜组(P<0.05);两组的其他指标比较,差异无统计学意义(P>0.05)。结论达芬奇机器人非小细胞肺癌手术在淋巴结清扫数量及中期术后疗效上略优于胸腔镜手术。Objective To investigate the treatment outcome of lobectomy for non-small cell lung cancer with da Vinci Surgical System. Methods From Jan. 2012 to Jan. 2015, 202 patients with non- small cell lung cancer underwent lobectomy and systematic node dissection. 80 patients underwent robotassisted thoracic surgery（RATS） （RATS group） and 122 patients underwent video-assisted thoracic surgery （VATS） （ VATS group）. To compare and analyze the condition of lmphy nodes dissection and outcomes of patients in the two groups. Results There were significant difference between RATS group and VATS group in dissected total number of lmphy node [ （16.93 ± 8.00） vs （13.98 ± 8.67） ] and team [ （4.89 ± 1.57） vs （4.25 ± 1.23）] ,the 2 years disease free survival rate （71.2% vs 57.4%）,the dissected number of lmphy node of stage I [（16.59 ± 8.57） vs （11.86 ± 6.61）],the 2 years disease free survival rate （ 84.3% vs 57.8% ） and overall survival rate （96.1% vs 84.4% ）. There were also significant difference between two groups in blood loss [ （57 ± 49）ml vs （211 ± 180）ml ] ,drainage volume [POD 1 （255 ± 116）mlvs （332 ± 175） ml,POD 2（259 ± 114）ml vs （321 ± 172）ml . Whereas there were no significant difference between the two groups in other outcomes. Conclusion The RATS dissected more number of lmphy node and took better median outcomes than VATS in NSCLC.

关 键 词：达芬奇机器人手术 胸腔镜手术 淋巴结清扫 非小细胞肺癌 生存率 无进展生存率 

分 类 号：R734.2[医药卫生—肿瘤]