单孔胸腔镜与单孔机器人辅助胸腔镜下袖式肺叶切除术的效果对比(附手术视频)  

Effect of uniportal video-assisted versus robot-assisted thoracoscopic sleeve lobectomy(with surgical video)

作　　者：李纪文 张亚锋[2] 梅娜 张文天 宁晔 蒋雷[4] LI Jiwen;ZHANG Yafeng;MEI Na;ZHANG Wentian;NING Ye;JIANG Lei(Department of Thoracic Surgery,Affiliated Hospital of Chifeng University,Chifeng 024005,China;Department of Thoracic Surgery,Jinshan Branch,Shanghai Sixth People’s Hospital,Shanghai 201599,China;Department of Oncology,Shanghai Hospital of Traditional Chinese Medicine,Shanghai 200071,China;Department of Thoracic Surgery,Shanghai Pulmonary Hospital Affiliated to Tongji University,Shanghai 200433,China)

机构地区：[1]赤峰学院附属医院胸外科,内蒙古赤峰024005 [2]上海市第六人民医院金山分院胸外科,上海201599 [3]上海市中医医院肿瘤科,上海200071 [4]同济大学附属上海肺科医院胸外科,上海200433

出　　处：《机器人外科学杂志(中英文)》2025年第3期388-391,397,共5页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金青年科学基金(82103309)。

摘　　要：目的:对比单孔胸腔镜(UVATS)与单孔机器人辅助胸腔镜下(URATS)袖式肺叶切除术在围手术期、手术技巧与患者术后恢复方面的差异,评价两种手术方法的可行性及优缺点。方法:回顾性分析2022年1月—2022年10月于同济大学附属上海肺科医院行袖式肺叶切除术的43例患者的临床资料,根据手术方式的不同分为UVATS组(n=23)和URATS组(n=20),并比较两组患者的手术时间、术中出血量、淋巴结清扫数量、术后引流量、术后住院时间及围手术期并发症发生情况等。结果:所有患者手术顺利完成,无中转开胸及围手术期死亡,术后拔除胸腔引流管后出院。URATS组的手术操作时间(除机器人装机时间)、气管吻合时间、术中出血量、术后1 d引流量及术后并发症发生率明显少于UVATS组(P<0.05);两组患者的总手术时间、淋巴结清扫数量、术后住院时间及引流管留置时间比较,差异无统计学意义(P>0.05)。结论:UVATS袖式肺叶切除术与URATS袖式肺叶切除术均安全可行;URATS在缩短游离肺门、吻合支气管所需时间及减少术中、术后引流量方面较UVATS更具优势。Objective:To compare the differences in the perioperative period,operative skills,and postoperative recovery between uniportal video-assisted thoracoscopic surgery(UVATS)and uniportal robot-assisted thoracoscopic surgery(URATS)in sleeve lobectomy and evaluate the feasibility,advantages and disadvantages of the two surgical methods.Methods:43 patients who underwent sleeve lobectomy in Shanghai Pulmonary Hospital from January 2022 to October 2022 were retrospectively selected.They were divided into the UVATS group(n=23)and the URATS group(n=20)according to different surgical methods.The operative time,intraoperative bleeding loss,lymph node dissection quantity,postoperative drainage volume,length of postoperative hospital stay,and the occurrence of perioperative complications were compared between the two groups of patients.Results:All surgeries underwent smoothly without death or conversion to open surgery,and all patients were discharged from the hospital after removal of chest drains.The surgical time(except for the robot loading time),tracheal anastomosis time,intraoperative bleeding,postoperative drainage at 1 d after surgery,and incidence of postoperative complications in the URATS group were significantly less than those in the UVATS group(P<0.05).Howerer,the total operative time,lymph node dissection quantity,length of postoperative hospital stay,and drainage tube retention time showed no significant difference between the two groups(P>0.05).Conclusion:Both UVATS and URATS for sleeve lobectomy are safe and feasible.URATS outperforms UVATS in reducing the time required for free hilar and anastomotic bronchial closure,as well as decreasing the intraoperative and postoperative drainage.

关 键 词：单孔机器人辅助胸腔镜手术 单孔胸腔镜手术 袖式肺叶切除术 

分 类 号：R655.3[医药卫生—外科学]