机器人与胸腔镜肺段切除术治疗非小细胞肺癌的倾向性评分匹配研究  

Robotic and thoracoscopic segmentectomy in the treatment for non-small cell lung cancer:A propensity score-matched study

作　　者：吴晓 徐金明[1] 王莺[2] 倪彭智 汪路明[1] 何哲浩[1] 胡坚[1] WU Xiao;XU Jinming;WANG Ying;NI Pengzhi;WANG Luming;HE Zhehao;HU Jian(Department of Cardiovascular and Thoracic Surgery,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,310000,P.R.China;Department of Operating Room,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,310000,P.R.China)

机构地区：[1]浙江大学医学院附属第一医院胸外科,杭州310000 [2]浙江大学医学院附属第一医院手术室,杭州310000

出　　处：《中国胸心血管外科临床杂志》2020年第10期1150-1154,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：浙江省重点研发计划(2020C03058);浙江省医药卫生一般研究计划(2019KY069)。

摘　　要：目的评估机器人肺段切除术的安全性和有效性。方法回顾性收集2015年6月至2019年6月于浙江大学医学院附属第一医院行机器人或胸腔镜肺段切除术的110例早期非小细胞肺癌患者的临床资料。根据手术方式将患者分为机器人组和胸腔镜组,其中机器人组50例,男13例、女37例,平均年龄53.0(46.0,60.0)岁;胸腔镜组60例,男21例、女39例,平均年龄61.0(53.0,67.0)岁。对两组患者进行倾向性评分匹配,并比较两组患者的围手术期资料。结果经倾向性评分匹配后,两组各纳入34例患者。与胸腔镜组相比,机器人组患者的术中出血量更少[40.0(20.0,50.0)mL vs.60(40.0,80.0)mL,P<0.001],淋巴结清扫站数更多[7.0(6.0,8.0)vs.4.0(3.0,6.0),P<0.001],淋巴结清扫个数更多[15.0(11.0,21.0)vs.10.0(6.0,14.0),P=0.002],住院总费用更高[9.7(9.2,10.3)万元vs.5.4(4.2,5.9)万元,P<0.001]。结论机器人肺段切除术具有与胸腔镜手术相似的安全性,且术中出血量更少、淋巴结清扫更彻底。Objective To investigate the safety and efficiency of robotic lung segmentectomy.Methods The clinical data of 110 patients receiving robotic or thoracoscopic segmentectomy in our hospital between June 2015 and June 2019 were retrospectively analyzed.The patients were divided into a robotic group[n=50,13 males and 37 females aged 53.0(46.0,60.0)years]and a thoracoscopic group[n=60,21 males and 39 females aged 61.0(53.0,67.0)years].A propensity score-matched analysis was adopted to compare the perioperative data between the two groups.Results After the propensity score-matched analysis,34 patients were included in each group.In comparison with the thoracoscopic group,patients in the robotic group had less blood loss[40.0(20.0,50.0)mL vs.60.0(40.0,80.0)mL,P<0.001],more stations of lymph node dissection[7.0(6.0,8.0)vs.4.0(3.0,6.0),P<0.001],larger number of lymph node dissection[15.0(11.0,21.0)vs.10.0(6.0,14.0),P=0.002],and a higher total cost of hospitalization[97.0(92.0,103.0)thousand yuan vs.54.0(42.0,59.0)thousand yuan,P<0.001].Conclusion In contrast with the thoracoscopic segmentectomy,robotic segmentectomy has a similar operative safety,but less blood loss and a thorough lymphadenectomy.

关 键 词：肺癌 肺段切除 机器人手术 电视辅助胸腔镜手术 外科 

分 类 号：R734.2[医药卫生—肿瘤]