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机器人系统支气管袖状切除术与开胸手术治疗中央型肺癌的近期和中期生存比较。

Short-term and mid-term survival in bronchial sleeve resection by robotic system versus thoracotomy for centrally located lung cancer.

机构信息

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Eur J Cardiothorac Surg. 2018 Mar 1;53(3):648-655. doi: 10.1093/ejcts/ezx355.

DOI:10.1093/ejcts/ezx355
PMID:29029111
Abstract

OBJECTIVES

The aim of this study was to compare the short-term and mid-term results of patients with centrally located lung cancer who underwent bronchial sleeve resection by robotic system or thoracotomy.

METHODS

From September 2014 to September 2015, 103 patients, including 17 robotic and 86 open cases, were included in our study. All the clinicopathological data, operative details and follow-up information were investigated.

RESULTS

There were no intraoperative deaths. The mean console time was 113.59 min. The operative time for robotic surgery (155.06 ± 44.75 min), even in our initial cases, was comparable to that for thoracotomy (150.30 ± 47.84 min, P = 0.71). The 30-day mortality rate in the robotic and thoracotomy groups was 1 (6%) patient and 2 (2%) patients, respectively, with no significant difference (P = 0.43). A total of 4 (24%) patients in the robotic group and 22 (26%) patients in the thoracotomy group experienced postoperative complications (P = 0.86). In multivariable analysis, tumour size and postoperative radiotherapy were significant predictors of relapse-free survival, whereas only the intensive care unit stay was a significant predictor of overall survival. There was no significant difference in relapse-free survival (log-rank P = 0.16) and overall survival (log-rank P = 0.59) between the 2 groups.

CONCLUSIONS

Robotic surgery for bronchial sleeve resection is safe and feasible and has similar oncological outcomes compared with open procedures. But long-term survival still needs to be investigated.

摘要

目的

本研究旨在比较接受机器人系统或开胸手术的中央型肺癌患者的短期和中期结果。

方法

2014 年 9 月至 2015 年 9 月,我们研究纳入了 103 例患者,包括 17 例机器人组和 86 例开胸组。所有临床病理数据、手术细节和随访信息均进行了调查。

结果

术中无死亡。控制台时间平均为 113.59 分钟。机器人手术的手术时间(155.06±44.75 分钟),即使在我们的初始病例中,与开胸手术(150.30±47.84 分钟,P=0.71)相当。机器人组和开胸组的 30 天死亡率分别为 1(6%)例和 2(2%)例,差异无统计学意义(P=0.43)。机器人组共有 4(24%)例患者和开胸组 22(26%)例患者发生术后并发症(P=0.86)。多变量分析显示,肿瘤大小和术后放疗是无复发生存的显著预测因素,而只有重症监护病房停留是总生存的显著预测因素。两组之间无复发生存(对数秩 P=0.16)和总生存(对数秩 P=0.59)无显著差异。

结论

支气管袖状切除术机器人手术安全可行,与开放手术相比具有相似的肿瘤学结果。但长期生存仍需进一步研究。

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