达芬奇机器人手术辅助系统治疗胸腺疾病的疗效分析  

Analysis of the effects of da Vinci robotic surgery in the treatment of thymic diseases

作　　者：王康[1] 秦涛[1] 易俊[1] 刘小龙[1] 钱建军[1] 熊磊[1] 申翼[1] 李德闽[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)心胸外科,南京医学硕士210002

出　　处：《医学研究生学报》2017年第6期628-631,共4页Journal of Medical Postgraduates

基　　金：南京军区南京总医院科研基金(2014033)

摘　　要：目的胸腔镜在微创治疗方面虽具有独特优势,但要完整切除胸腺仍存在一些困难,机器人辅助胸腔镜手术弥补了胸腔镜的不足。文中旨在总结分析达芬奇机器人手术和胸腔镜手术治疗胸腺疾病的临床效果差异。方法回顾性分析南京军区南京总医院胸外科2013年6月至2015年6月采用达芬奇机器人手术系统实施了胸腺切除手术的65例胸腺病变患者(机器人组);以及同期收治的51例采用胸腔镜手术的胸腺病变患者(胸腔镜组)的临床资料。对比2组手术时间、拔胸管时间、术中出血量、术后24 h引流量等。结果机器人组拔胸管时间、术后SICU天数、术后住院天数较胸腔镜组明显缩短[(2.54±0.32)d vs(2.87±0.49)d,(0.75±0.04)d vs(0.81±0.06)d、(5.17±0.15)d vs(5.50±0.23)d,P<0.05],机器人组术中出血量(mL)、术后24 h引流量(cm)明显优于胸腔镜组[(125.7±7.5)mL vs(136.6±8.2)mL、(117.38±11.45)mL vs(122.41±13.14)mL,P<0.05]。结论达芬奇机器人手术治疗胸腺病变具有创伤小,恢复快等优势,在一定程度上弥补了胸腔镜技术的不足。Objective Although minimally invasive thoracoscopic surgery has unique advantages, there are still some diffi- culties in the complete resection of the thymus. Video-assisted thoracoscopic surgery has made up for the lack of thoracoscopy. This arti- cle summarize and analyze the clinical effects of DaVinci robotic surgery and thoracic surgery in the treatment of thymic diseases. Methods 116 cases of patients with thymic lesion were included in the study. According to the different treatment methods, 65 cases were included in da Vinci robotic group and other 51 cases were thoracoscopic group. Comparison was made in operating time, time of chest tube extubation, bleeding volume during surgery and amount of drainage within 24 h after the operation between two groups. Results There were no statistical differences between robot group and thoracoscopic group in operating time（P〉0.05）. The time of pulling out the chest tube in robot group, postoperative days in surgical intensive care unit （SICU）, and postoperative hospitalization days were significantly shorter than those in thoracoscopic group （ [2.54±0.32]d vs [2.87±0.49]d, [0.75±0.04]d vs [0.81±0.06]d, [ 5.17±0.15 ] d vs [ 5.50±0.23 ] d, P〈0.05）. The bleeding volume during surgery and amount of drainage within 24h after the operation in robot group had a significant advantage over those in thoracoscopic group （ [ 125.7±7.51 mL vs [ 136.6±8.2 ] mL, [ 117.38± 11.45 ] mL vs [ 122.41± 13.14 ] mL, P〈0.05）. Conclusion The da Vinci robotic surgery has the advantages of minimal trauma and rapid re- covery, which makes up for the deficiency of thoracoscopy to a certain extent.

关 键 词：胸腺 重症肌无力 胸腔镜 达芬奇机器人 

分 类 号：R655.7[医药卫生—外科学]