Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
World J Surg Oncol. 2018 Apr 2;16(1):74. doi: 10.1186/s12957-018-1374-x.
Few studies have described robotic sleeve resection with pulmonary resection. Here, we report the successful implementation of a completely portal robotic sleeve resection with or without pulmonary resection using a modified suture mode.
In total, 339 patients underwent curative robotic pulmonary surgery at Ruijin Hospital between May 2015 and September 2017. Three of these patients underwent robotic sleeve resection (right upper lobe, one; left upper lobe, one; and lingular segmental bronchus, one). Five port incisions were utilized, and a simple continuous running suture combined with two interrupted sutures of the membranous and cartilaginous junction portion was preferred for the anastomosis.
The postoperative course was uneventful for two patients with squamous cell carcinoma. The lingular segmental bronchus patient without pulmonary resection (a salivary gland tumor) underwent short-term atelectasis. The median operation time was 155 (range 132-230) minutes. The median anastomosis time was 25 (range 23-32) minutes. The median length of postoperative hospital stay was 7 (range 6-10) days. There was no mortality or conversion to thoracotomy for any of the patients. All patients were followed for 3-6 months, and there is no tumour recurrence.
Our limited experience suggested that robotic sleeve resection for pulmonary disease with or without pulmonary resection may be safe and effective. The anastomosis time can be shortened with more robotic surgery experiences and the modified suture mode.
很少有研究描述过机器人袖状切除术与肺切除术。在这里,我们报告了使用改良缝合模式成功实施完全经端口机器人袖状切除术(伴或不伴肺切除术)的经验。
2015 年 5 月至 2017 年 9 月,瑞金医院共有 339 例患者接受了根治性机器人肺外科手术。其中 3 例患者接受了机器人袖状切除术(右上叶 1 例,左上叶 1 例,舌段支气管 1 例)。使用 5 个端口切口,优选使用简单的连续运行缝合,结合膜部和软骨结合部的两个间断缝合进行吻合。
两名患有鳞状细胞癌的患者术后恢复顺利。无肺切除术(涎腺肿瘤)的舌段支气管患者发生短期肺不张。中位手术时间为 155 分钟(范围 132-230 分钟)。中位吻合时间为 25 分钟(范围 23-32 分钟)。中位术后住院时间为 7 天(范围 6-10 天)。所有患者均无死亡或转为开胸手术。所有患者均随访 3-6 个月,无肿瘤复发。
我们的有限经验表明,伴或不伴肺切除术的机器人袖状切除术治疗肺部疾病可能是安全有效的。随着更多的机器人手术经验和改良的缝合模式,吻合时间可以缩短。