Terra Ricardo Mingarini, Lauricella Leticia Leone, Haddad Rui, de-Campos José Ribas Milanes, Nabuco-de-Araujo Pedro Henrique Xavier, Lima Carlos Eduardo Teixeira, Santos Felipe Carvalho Braga Dos, Pego-Fernandes Paulo Manuel
Hospital Sírio Libanês, Serviço de Cirurgia Torácica, São Paulo, SP, Brasil.
Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação, Disciplina de Cirurgia Torácica, Rio de Janeiro, RJ, Brasil.
Rev Col Bras Cir. 2019 Sep 30;46(4):e20192210. doi: 10.1590/0100-6991e-20192210. eCollection 2019.
to report our initial experience with pulmonary robotic segmentectomy, describing the surgical technique, the preferred positioning of portals, initial results and outcomes.
we collected data, from a prospective robotic surgery database, on patients undergoing robotic segmentectomy between January 2017 and December 2018. All patients had lung cancer, primary or secondary, or benign diseases, and were operated on with the Da Vinci system, by the three portals technique plus one utilitarian incision of 3cm. We dissected the hilar structures individually and performed the ligatures of the arterial and venous branches, of the segmental bronchi, as well as a parenchymal transection, with endoscopic staplers. We carried out systematic dissection of mediastinal lymph nodes for non-small cell lung cancer (NSCLC) cases.
forty-nine patients, of whom 33 were women, underwent robotic segmentectomy. The average age was of 68 years. Most patients had NSCLC (n=34), followed by metastatic disease (n=11) and benign disease (n=4). There was no conversion to laparoscopic or open surgery, or to lobectomy. The median total operative time was 160 minutes, and the median console time, 117 minutes. Postoperative complications occurred in nine patients (18.3%), of whom seven (14.2%) had prolonged hospitalization (>7 days) due to persistent air fistula (n=4; 8.1%) or abdominal complications (n=2.4%).
robotic segmentectomy is a safe and viable procedure, offering a short period of hospitalization and low morbidity.
报告我们在肺部机器人肺段切除术方面的初步经验，描述手术技术、切口的首选定位、初步结果和结局。
我们从一个前瞻性机器人手术数据库中收集了2017年1月至2018年12月期间接受机器人肺段切除术患者的数据。所有患者均患有原发性或继发性肺癌或良性疾病，并使用达芬奇系统通过三切口技术加一个3cm的实用切口进行手术。我们分别解剖肺门结构，并用内镜吻合器对动脉和静脉分支、肺段支气管进行结扎，以及进行实质横断。对于非小细胞肺癌（NSCLC）病例，我们进行了纵隔淋巴结的系统性清扫。
49例患者接受了机器人肺段切除术，其中33例为女性。平均年龄为68岁。大多数患者患有NSCLC（n = 34），其次是转移性疾病（n = 11）和良性疾病（n = 4）。没有转为腹腔镜手术、开放手术或肺叶切除术的情况。总手术时间中位数为160分钟，控制台操作时间中位数为117分钟。9例患者（18.3%）发生术后并发症，其中7例（14.2%）因持续性气胸（n = 4；8.1%）或腹部并发症（n = 2.4%）而延长住院时间（>7天）。
机器人肺段切除术是一种安全可行的手术，具有住院时间短和发病率低的特点。
