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机器人与单孔电视辅助胸腔镜手术治疗肺癌的早期结果:倾向评分匹配研究。

Early outcomes of robotic versus uniportal video-assisted thoracic surgery for lung cancer: a propensity score-matched study.

机构信息

Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Eur J Cardiothorac Surg. 2018 Feb 1;53(2):348-352. doi: 10.1093/ejcts/ezx310.

Abstract

OBJECTIVES

Both robotic-assisted thoracic surgery (RATS) and uniportal video-assisted thoracic surgery (UVATS) are minimally invasive surgical techniques used for treatment of lung cancer. However, no research studies comparing early outcomes between RATS and UVATS have been reported.

METHODS

Non-small-cell lung cancer patients treated with RATS or UVATS at our institution from January 2015 to September 2016 were enrolled. Early outcomes were compared after propensity score-matched analysis using 4 factors: age, gender, tumour size and operative procedure.

RESULTS

A total of 153 patients were included in this study: 76 patients underwent RATS and 77 patients underwent UVATS. After propensity score-matched analysis, each group included 69 cases. The comparison of the 2 groups showed that there were no significant differences in operative time, postoperative hospital stay, chest tube duration, analgesic usage, complications or the number of resected lymph nodes. However, RATS caused less intraoperative blood loss (P = 0.037) and more dissected lymph node stations (P = 0.014).

CONCLUSIONS

Judging from the short-term outcomes, both RATS and UVATS are safe and feasible for non-small-cell lung cancer treatment. In particular, RATS is better able to reduce bleeding and complete lymphadenectomy than UVATS.

摘要

目的

机器人辅助胸腔手术(RATS)和单孔电视辅助胸腔手术(UVATS)都是用于治疗肺癌的微创手术技术。然而,目前尚未有研究比较 RATS 和 UVATS 之间的早期结果。

方法

我们机构在 2015 年 1 月至 2016 年 9 月期间对接受 RATS 或 UVATS 治疗的非小细胞肺癌患者进行了研究。在使用 4 个因素(年龄、性别、肿瘤大小和手术程序)进行倾向评分匹配分析后,比较了早期结果。

结果

本研究共纳入 153 例患者:76 例患者接受 RATS 治疗,77 例患者接受 UVATS 治疗。经过倾向评分匹配分析后,每组包括 69 例患者。两组之间的比较显示,手术时间、术后住院时间、胸腔引流管留置时间、镇痛药使用、并发症或切除的淋巴结数量均无显著差异。然而,RATS 术中出血量更少(P=0.037),淋巴结清扫站数更多(P=0.014)。

结论

从短期结果来看,RATS 和 UVATS 对非小细胞肺癌的治疗都是安全可行的。特别是,RATS 比 UVATS 更能减少出血并完成淋巴结清扫。

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