Buitrago Miguel Ricardo, Restrepo Juliana
Department of Thoracic Surgery, Instituto Nacional de Carcerología, Universidad Militar Nueva Granada, Bogotá, Colombia.
Department of Thoracic Surgery, Clínica de Marly, Bogotá, Colombia.
Ann Cardiothorac Surg. 2019 Mar;8(2):233-240. doi: 10.21037/acs.2019.03.01.
Robotic assisted videothoracoscopic surgery (RVATS) adoption has increased worldwide from 3.4% in 2010 to 17.5% in 2015. However, in Latin America, the literature is limited to a report of a series of 10 patients who underwent RVATS lobectomy and one case report of an RVATS thymectomy from Brazil.
This is a retrospective review of all RVATS performed in Bogotá Colombia since 2012. A single thoracic surgeon (RB) performed all the operations at three institutions: Clínica de Marly, Fundación Clínica Shaio and Instituto Nacional de Cancerología. Preoperative, intraoperative, postoperative and pathology report variables were included. Patients were analyzed in three groups: robotic RVATS pulmonary resections, RVATS mediastinal surgeries and other RVATS procedures. Descriptive statistics were used to report the median and interquartile range (IQR) of the continuous variables, and number and percentage were used to describe categorical variables. The association between total operative time and the year the surgery was analyzed using a linear regression model.
Forty-seven patients underwent RVATS pulmonary resections; 72.3% (n=34) of these patients underwent a RVATS lobectomy. The median total operative time was 220 (IQR: 200 to 250) minutes, 6.4% (n=3) had intraoperative complications, and the most frequent histologic diagnosis was adenocarcinoma (n=24, 51.1%). Of 18 patients who underwent RVATS mediastinal surgeries, 50.0% (n=9) had RVATS thymectomy, the median total operative time was 195.5 (IQR: 131 to 221) minutes and two patients (11.1%) had intraoperative complications. The linear regression model of the association between total operative time and the year the surgery showed a 10.3 minute reduction per year (P=0.006).
This is the second series of RVATS published in Latin America and the first published in Colombia, with comparable perioperative results to other reports.
机器人辅助电视胸腔镜手术（RVATS）在全球的应用率已从2010年的3.4%增至2015年的17.5%。然而，在拉丁美洲，相关文献仅限于一篇关于10例行RVATS肺叶切除术患者的系列报道以及一篇来自巴西的RVATS胸腺切除术病例报告。
这是一项对自2012年以来在哥伦比亚波哥大进行的所有RVATS手术的回顾性研究。由一名胸外科医生（RB）在三家机构进行了所有手术，分别是Clínica de Marly、Fundación Clínica Shaio和Instituto Nacional de Cancerología。纳入术前、术中、术后及病理报告变量。患者分为三组：机器人RVATS肺切除术、RVATS纵隔手术及其他RVATS手术。采用描述性统计报告连续变量的中位数和四分位数间距（IQR），并使用数量和百分比描述分类变量。使用线性回归模型分析总手术时间与手术年份之间的关联。
47例患者接受了RVATS肺切除术；其中72.3%（n = 34）的患者接受了RVATS肺叶切除术。总手术时间中位数为220（IQR：200至250）分钟，6.4%（n = 3）有术中并发症，最常见的组织学诊断为腺癌（n = 24，51.1%）。在18例接受RVATS纵隔手术的患者中，50.0%（n = 9）行RVATS胸腺切除术，总手术时间中位数为195.5（IQR：131至221）分钟，2例患者（11.1%）有术中并发症。总手术时间与手术年份关联的线性回归模型显示每年减少10.3分钟（P = 0.006）。
这是拉丁美洲发表的第二篇RVATS系列报道，也是哥伦比亚发表的第一篇，围手术期结果与其他报道相当。
