达芬奇机器人辅助支气管袖式肺叶切除术的围术期疗效和安全性分析  

Perioperative efficacy and safety of da Vinci robot-assisted bronchial sleeve lobectomy

作　　者：张斯渊 董信春 苟云久[1] 韩松辰 陈猛 金大成 ZHANG Siyuan;DONG Xinchun;GOU Yunjiu;HAN Songchen;CHEN Meng;JIN Dacheng(Department of Thoracic Surgery,Gansu Provincial Hospital,Lanzhou,730000,P.R.China;School of Clinical Medicine,Gansu University of Traditional Chinese Medicine,Lanzhou,730000,P.R.China)

机构地区：[1]甘肃省人民医院胸外科,兰州730000 [2]甘肃中医药大学临床医学院,兰州730000

出　　处：《中国胸心血管外科临床杂志》2020年第10期1145-1149,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：甘肃省卫生行业计划(GSWSKY2017-56);甘肃省人民医院院内科研基金(16GSSY3-1)。

摘　　要：目的通过分析达芬奇机器人辅助支气管袖式肺叶切除术的围术期结局,总结其安全性与有效性。方法回顾性分析2019年3~12月我中心完成的机器人辅助中央型肺癌袖式切除10例患者的临床资料,其中男9例、女1例,年龄45~67(55.0±8.9)岁,术前通过影像学与支气管镜检查均提示中央型非小细胞肺癌,其中右肺上叶3例,右肺下叶2例,左肺上叶4例,左肺下叶1例。对手术时间、装机时间、术中出血量、支气管吻合时间、清扫淋巴结数目、术后胸腔引流量、住院时间进行数据处理分析。结果10例患者均在达芬奇机器人辅助下顺利完成支气管袖式肺叶切除,手术时间135~183(157.8±14.3)min,装机时间6~15(10.0±2.9)min,术中出血量55~250(124.5±61.8)mL,支气管吻合时间17~40(27.7±7.3)min,清扫淋巴结数目16~23(19.7±2.8)枚,术后胸腔引流量200~600(348.0±148.4)mL,住院时间7~11(8.7±1.6)d。无支气管胸膜瘘、肺部感染和肺不张等并发症发生,无围术期死亡病例。术后病理均为鳞状细胞癌。结论达芬奇机器人辅助支气管袖式肺叶切除术安全有效。Objective Through the perioperative outcome analysis of da Vinci robot-assisted sleeve lobectomy,to clarify its efficacy and safety.Methods A retrospective analysis was performed on 10 patients with centrally located lung cancer undergoing robot-assisted sleeve lobectomy from March to December 2019 in our center,including 9 males and 1 female,aged 45-67(55.0±8.9)years.Preoperative imaging and bronchoscopy showed central non-small cell lung cancer,involving the right upper lung in 3 patients,right lower lung in 2 patients,the left upper lung in 4 patients,and left lower lung in 1 patient.The operation time,Docking time,intraoperative blood loss volume,bronchial anastomosis time,number of dissected lymph nodes,drainage volume and postoperative hospital stay were analyzed.Results The da Vinci robot-assisted bronchial sleeve lobectomy was completed smoothly on 10 patients.The operation time was 135-183(157.8±14.3)min,Docking time 6-15(10.0±2.9)min,intraoperative blood loss volume 55-250(124.5±61.8)mL,bronchial anastomosis time 17-40(27.7±7.3)min,the number of dissected lymph nodes 16-23(19.7±2.8),the drainage volume 200-600(348.0±148.4)mL and postoperative hospital stay 7-11(8.7±1.6)d.All patients had no bronchopleural fistula,pulmonary infection or atelectasis,and there was no perioperative death.Postoperative pathological findings were all squamous cell carcinoma.Conclusion Da Vinci robot-assisted sleeve lobectomy is safe and effective.

关 键 词：非小细胞肺癌 达芬奇机器人系统 袖式肺叶切除术 外科手术 

分 类 号：R734.2[医药卫生—肿瘤]