机器人辅助胸腔镜手术治疗后纵隔神经源性肿瘤的临床疗效分析  

Clinical efficacy of robot-assisted thoracoscopic surgery for posterior mediastinal neurogenic tumour

作　　者：洪子强 金大成 白向豆 成涛 吴旭升 崔百强 苟云久[2] HONG Ziqiang;JIN Dacheng;BAI Xiangdou;CHENG Tao;WU Xusheng;CUI Baiqiang;GOU Yunjiu(The First Clinical Department of Gansu University of Traditional Chinese Medicine,Lanzhou,730000,P.R.China;Department of Thoracic Surgery,Gansu Provincial People's Hospital,Lanzhou,730000,P.R.China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院胸外科,兰州730000

出　　处：《中国胸心血管外科临床杂志》2024年第3期408-412,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：甘肃省人民医院国家自然科学基金抚育项目(19SYPYB-28);甘肃省自然科学基金(20JR10RA388);甘肃省卫生健康行业科研管理项目(GSWSKY2020-50)。

摘　　要：目的 评估机器人辅助胸腔镜手术(robot-assisted thoracoscopic surgery,RATS)治疗后纵隔神经源性肿瘤的短期疗效。方法 回顾性分析2016年6月—2022年6月甘肃省人民医院胸外科经同一术者连续完成的RATS治疗后纵隔神经源性肿瘤患者的临床资料。所有患者术前采用磁共振成像或增强CT定位并评估肿瘤。结果 共纳入35例患者,其中男19例、女16例,平均年龄(34.9±7.1)岁。患者均在RATS下成功完成后纵隔神经源性肿瘤切除,无中转开胸。平均手术时间(62.3±18.0)min,装机时间(10.3±2.6)min,术中出血量(33.9±21.6)mL,术后24 h胸腔引流量(69.0±28.9)mL,术后胸腔引流时间2.0(1.0,3.0)d,术后住院时间3.0(2.0,4.0)d。3例患者出现术后并发症,其中术后一过性Honor综合征2例,一过性患侧上肢无汗1例。结论 RATS治疗后纵隔神经源性肿瘤安全、有效、可行,可充分发挥机器人手术系统的优势。Objective To evaluate the short-term outcome of robot-assisted thoracoscopic surgery(RATS)for the treatment of posterior mediastinal neurogenic tumour.Methods The clinical data of consecutive patients with mediastinal neurogenic tumors who received RATS treatment completed by the same operator in the Department of Thoracic Surgery,Gansu Provincial People's Hospital from June 2016 to June 2022 were retrospectively analyzed.The tumors were preoperatively localized and evaluated using magnetic resonance imaging or enhanced CT.Results A total of 35 patients were enrolled,including 19 males and 16 females with a mean age of 34.9±7.1 years.All patients successfully completed the resection of posterior mediastinal neurogenic tumors under RATS,and no conversion to thoracotomy occurred during the operation.The average operative time was 62.3±18.0 min,docking time was 10.3±2.6 min,intraoperative bleeding was 33.9±21.6 mL,postoperative 24-hour chest drainage was 69.0±28.9 mL,postoperative chest drainage time was 2.0(1.0,3.0)d and the postoperative hospital stay was 3.0(2.0,4.0)d.Postoperative complications occurred in 3 patients,including 2 patients with transient Honor syndrome and 1 patient with transient anhidrosis of the affected upper limb.Conclusion RATS for posterior mediastinal neurogenic tumours is safe,effective and feasible,and allows the full benefit of the robotic surgical system to be exploited.

关 键 词：机器人辅助胸腔镜手术 微创胸外科手术 纵隔肿瘤 神经源性肿瘤 

分 类 号：R734.5[医药卫生—肿瘤]