机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌疗效的对比研究  

Comparison analysis of robot-assisted and video-assisted thoracic surgery segmentectomy for early stage non-small cell lung cancer

作　　者：贾卓奇[1] 王绩钊 王哲[1] 张勇[1] 吴齐飞[1] 张广健[1] 付军科[1] JIA Zhuoqi;WANG Jizhao;WANG Zhe;ZHANG Yong;WU Qifei;ZHANG Guangjian;FU Junke(Department of Thoracic Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院胸外科,陕西西安710061

出　　处：《现代肿瘤医学》2024年第9期1648-1652,共5页Journal of Modern Oncology

基　　金：西安交通大学第一附属医院科研发展基金(编号:2020ZYTS-21)。

摘　　要：目的:对比分析达芬奇机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。方法:回顾性分析2016年06月至2020年12月,于我院胸外科行微创肺段切除术的早期非小细胞肺癌患者,共纳入134例,分为机器人组(robot-assisted thoracic surgery,RATS)47例,胸腔镜组(video-assisted thoracic surgery,VATS)87组,对比分析两组临床特征及手术指标、术后主要并发症情况及费用。结果:手术时间、术中出血、平均住院日、术后引流时间等,RATS组优于VATS组,但两组差异无统计学意义(P>0.05)。术后并发症如肺炎、胸腔积液、心律失常、肺不张发生率,两组间差异无统计学意义(P>0.05)。超过5天漏气率RATS组为6.3%,低于VATS组的10.3%,差异有统计学意义(P<0.05)。两组术后NRS疼痛评分差异无统计学意义(P>0.05)。RATS组住院费用明显高于胸腔镜组,差异有统计学意义(P<0.05)。两组1年生存率和2年生存率差异均无统计学意义(P>0.05)。结论:机器人肺段切除术治疗早期非小细胞肺癌安全可行,与胸腔镜相比,术后长期漏气发生较少,值得推广应用。Objective:To compare the clinical efficacy of Da-Vinci robot-assisted and video-assisted thoracic surgery segmentectomy for early stage non-small cell lung cancer(NSCLC).Methods:From June 2016 to December 2020,total of 134 early stage non-small cell lung cancer patients who accepted minimally invasive segmentectomy in department of thoracic surgery of our hospital,were analyzed retrospectively,including robot-assisted thoracic surgery(RATS)group(n=47)and video-assisted thoracic surgery(VATS)group(n=87).The clinical efficacy,post-operative complications and hospitalization cost of two groups were compared and analysed.Results:The operation time,intraoperative bleeding,hospital stayand drain time in RATS group was better than VATS group,but no statistically significant difference(P>0.05).The rate of post-operative complications as pneumonia,pleural effusion,arrhythmia and atelectasis of two group were not statistically difference(P>0.05).The rate of air leak>5 d in RATS group(6.3%)was lower than VATS group(10.3%),with statistically significant difference(P<0.05).And there was no difference in NRS pain score between two groups(P>0.05).In RATS group the hospitalization cost was higher than VATS group(P<0.05).There was no statistically difference in 1-year and 2-year survival rate between two groups(P>0.05).Conclusion:Robot-assisted segmentectomy for early stage NSCLC is safe and feasible,comparing with VATS,less air leak,so it's worth popularizing and applying.

关 键 词：非小细胞肺癌 达芬奇机器人手术 电视胸腔镜手术 肺段切除术 

分 类 号：R734.2[医药卫生—肿瘤]