Anderson Casandra A, Hellan Minia, Falebella Andres, Lau Clayton S, Grannis Fredric W, Kernstine Kemp H
From the Departments of *Surgical Oncology, †Anesthesia, ‡Urologic Oncology, and §Thoracic Surgery, City of Hope, Duarte, California.
Innovations (Phila). 2007 Sep;2(5):254-8. doi: 10.1097/IMI.0b013e31815e52f1.
: There have been few reports of the use of robotic surgery to resect lung malignancies. Feasibility and safety of robotic lung resection for malignant lung lesions will be assessed by performing a retrospective analysis.
: Between September 2004 and November 2006, 21 patients (11 male and 10 female patients) underwent robotic lung resection. Twenty resections were performed for primary nonsmall cell lung cancer and two for metastatic lesions. One patient had bilateral resections for two primary tumors. Fourteen lobectomies, five segementectomies, one wedge resection, and two bilobectomies were performed. Seventy-two percent of operative procedures included mediastinoscopy and/or bronchoscopy at the time of resection.
: Thirty-day mortality and conversion rate was 0%. The median operating room time and estimated blood loss was 3.6 hours and 100 mL, respectively. The median intensive care unit and total length of hospital stays were 2 and 4 days, respectively. Chest tubes were removed after a median of 2.0 days. The complication rate was 27%, which included atrial fibrillation, need for postoperative bronchoscopy, and pneumonia. The median tumor size and number of lymph nodes harvested was 2.3 cm and 16, respectively. All resection margins were negative. Median follow-up time was 9.8 months, with no local recurrences at this time.
: Robotic lung resection appears safe and feasible and allows for significant lymph node retrieval, offers short hospital stays and low morbidity for patients undergoing surgical resection of lung malignancies. Future studies are needed to define the role of robotic surgery in lung cancer treatment.
关于使用机器人手术切除肺部恶性肿瘤的报道较少。将通过进行回顾性分析来评估机器人肺切除术治疗肺部恶性病变的可行性和安全性。
2004年9月至2006年11月期间，21例患者（11例男性和10例女性）接受了机器人肺切除术。20例为原发性非小细胞肺癌切除术，2例为转移性病变切除术。1例患者因两个原发性肿瘤接受了双侧切除术。共进行了14例肺叶切除术、5例肺段切除术、1例楔形切除术和2例双肺叶切除术。72%的手术在切除时包括纵隔镜检查和/或支气管镜检查。
30天死亡率和中转开腹率为0%。中位手术时间和估计失血量分别为3.6小时和100毫升。中位重症监护病房停留时间和总住院时间分别为2天和4天。胸腔引流管中位拔除时间为2.0天。并发症发生率为27%，包括心房颤动、术后需要支气管镜检查和肺炎。中位肿瘤大小和切除淋巴结数量分别为2.3厘米和16个。所有切缘均为阴性。中位随访时间为9.8个月，目前无局部复发。
机器人肺切除术似乎安全可行，能显著清扫淋巴结，为接受肺部恶性肿瘤手术切除的患者提供较短的住院时间和较低的发病率。未来需要进一步研究来明确机器人手术在肺癌治疗中的作用。
