Department of Thoracic Surgery, Sakarya University, Faculty of Medicine, Sakarya, Turkey.
Department of Cardio-Vascular Surgery, Bolu Izzet Baysal University, Faculty of Medicine, Bolu, Turkey.
Asian J Surg. 2020 Jan;43(1):244-250. doi: 10.1016/j.asjsur.2019.04.005. Epub 2019 Apr 30.
In this study, the perioperative outcomes of video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) were compared in patients with clinical stage I and stage II thymoma.
The outcomes of 24 patients (10 males and 14 females; mean age: 42.5 years; range: 18-65 years) with diagnoses of clinical stage I and stage II thymoma who underwent VATS in our clinic between April 2010 and March 2018 were compared with the outcomes of 21 patients (8 males and 13 females; mean age: 41.2 years; range: 19-63 years) with the same clinical stages of thymoma who underwent RATS between March 2013 and May 2018. The operative times, postoperative complications, lengths of hospital stay, and total amounts of chest tube drainage of the patients were evaluated.
No postoperative mortality was observed in either group. In general, VATS was performed from the right side, and RATS was performed from the right hemithorax. The operative time was significantly longer in the VATS group than in the RATS group (106.5 min versus 75.7 min, respectively; p < 0.001). In the VATS group, the total amount of postoperative drainage from the chest tubes was greater than that in the RATS group (210 ml versus 325 ml, respectively), and the drainage time was longer in the VATS group than in the RATS group (3 days versus 5 days, respectively; p < 0.001). The length of hospital stay was longer for the patients in the VATS group than for those in the RATS group (5.3 days versus 4.1 days, respectively; p < 0.001). The levels of pain were similar in both groups. No difference in the complication rates was found between the 2 groups.
In the treatment of clinical stage I and stage II thymoma patients, the robotic approach and excision with VATS are techniques with equal reliability. However, the use of robot-assisted thoracoscopic thymectomy technique is advantageous in terms of decreasing the total amount of postoperative drainage and shortening the length of hospital stay.
本研究比较了电视辅助胸腔镜手术（VATS）和机器人辅助胸腔镜手术（RATS）在临床 I 期和 II 期胸腺瘤患者中的围手术期结果。
将 2010 年 4 月至 2018 年 3 月在我院接受 VATS 治疗的 24 例临床 I 期和 II 期胸腺瘤患者（男 10 例，女 14 例；平均年龄：42.5 岁；范围：18-65 岁）的结果与 2013 年 3 月至 2018 年 5 月接受 RATS 治疗的 21 例具有相同临床分期的胸腺瘤患者（男 8 例，女 13 例；平均年龄：41.2 岁；范围：19-63 岁）的结果进行比较。评估患者的手术时间、术后并发症、住院时间和胸腔引流总量。
两组均无术后死亡。一般来说，VATS 从右侧进行，RATS 从右侧胸腔进行。VATS 组的手术时间明显长于 RATS 组（分别为 106.5 分钟和 75.7 分钟；p<0.001）。VATS 组术后胸腔引流总量大于 RATS 组（分别为 210ml 和 325ml），引流时间长于 RATS 组（分别为 3 天和 5 天；p<0.001）。VATS 组患者的住院时间长于 RATS 组（分别为 5.3 天和 4.1 天；p<0.001）。两组患者的疼痛程度相似。两组并发症发生率无差异。
在治疗临床 I 期和 II 期胸腺瘤患者时，机器人方法和 VATS 切除具有同等可靠性。然而，机器人辅助胸腔镜胸腺切除术技术具有减少术后引流总量和缩短住院时间的优势。
