达芬奇机器人与胸腔镜外科治疗后纵隔肿物临床疗效比较的回顾性队列研究  

The clinical efficacy of Da Vinci robot versus video-assisted thoracoscopic surgery in the treatment of posterior mediastinal tumors:A retrospective cohort study

作　　者：王锋[1,2] 袁宇航 王晨晗 胡文滕 何立 杨文文 孙硕 张敏 韩彪[2] WANG Feng;YUAN Yuhang;WANG Chenhan;HU Wenteng;HE Li;YANG Wenwen;SUN Shuo;ZHANG Min;HAN Biao(The First Clinical Medical College of Lanzhou University,Lanzhou,730000,P.R.China;Department of Thoracic Surgery,The First Hospital of Lanzhou University,Lanzhou,730000,P.R.China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一医院胸外科,兰州730000

出　　处：《中国胸心血管外科临床杂志》2024年第5期695-701,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：甘肃省自然科学基金(21JR1RA118);甘肃省青年科技基金(18JR3RA305)。

摘　　要：目的比较机器人辅助胸腔镜手术(robot-assisted thoracoscopic surgery,RATS)与电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)治疗后纵隔肿物的围手术期疗效,探讨RATS辅助后纵隔肿物外科治疗的优势。方法回顾性分析2019年1月—2023年1月在兰州大学第一医院胸外科同一医疗组行侧胸入路后纵隔肿物切除术患者的临床资料。按不同手术方式将患者分为RATS组和VATS组。比较两组患者的临床资料。结果本研究共纳入85例患者,RATS组39例,其中男14例、女25例,平均年龄(47.6±13.0)岁,VATS组46例,其中男14例、女32例,平均年龄(45.3±14.7)岁。所有患者均顺利完成手术。RATS组的住院总费用高于VATS组(P<0.001);RATS组术后第1 d白细胞计数、中性粒细胞百分比均低于VATS组(P<0.05);两组患者手术时间、术中出血量、术后住院时间、术后第3 d白细胞计数和中性粒细胞百分比、术后第1 d和第3 d疼痛视觉模拟评分、止痛泵使用时间、术后12 h血氧饱和度(未吸氧)、术后开始下床活动时间、总胸腔引流量、引流管放置时间、术后相关并发症发生率差异均无统计学意义(P>0.05)。两组患者均无围手术期死亡,无中转开胸及围手术期严重并发症。结论运用RATS辅助经侧胸入路行后纵隔肿物切除术安全可行,其近期疗效与侧胸单孔入路VATS相当,值得进一步研究其获益与性价比。Objective To compare the short-term clinical effects of Da Vinci robot-assisted thoracic surgery(RATS)and video-assisted thoracoscopic surgery(VATS)in the treatment of posterior mediastinal tumors,and to explore the advantages of RATS posterior mediastinal tumor resection.Methods The clinical data of patients who underwent posterior mediastinal tumors resection through the lateral chest approach admitted to the same medical group in the Department of Thoracic Surgery of the First Hospital of Lanzhou University between January 2019 to January 2023 were retrospectively analyzed.According to the different surgical methods,the patients were divided into a RATS group and a VATS group.The clinical data were compared between the two groups.Results A total of 85 patients were included in this study.There were 39 patients in the RATS group,including 25 females and 14 males,with an average age of 47.6±13.0 years,and 46 patients in the VATS group,including 14 males and 32 females,with an average age of 45.3±14.7 years.All patients completed the operation successfully.The hospitalization cost in the RATS group was significantly higher than that in the VATS group(P<0.001),and the white blood cell count and neutrophilic granulocyte percentage on the first day after operation in the RATS group were lower than those in the VATS group,and the differences were statistically significant(P<0.05).The operative time,intraoperative bleeding,postoperative hospital stay,white blood cell count and neutrophil percentage on the third postoperative day,visual analogue scale score on the first and third postoperative days,duration of analgesic pump use,postoperative 12 h oxygen saturation(no oxygen inhalation),postoperative down bed time,total thoracic drainage volume,duration of drainage tube retention,and postoperative complication rates were not statistically different between the two groups(P>0.05).There was no perioperative death,conversion to thoracotomy or serious perioperative complications in both groups.Conclusion RATS resection o

关 键 词：后纵隔肿瘤 机器人辅助胸腔镜手术 侧胸入路 电视辅助胸腔镜手术 

分 类 号：R734.5[医药卫生—肿瘤]