Satoh Yukitoshi, Hayashi Shoko, Naito Masahito, Matsui Yoshio
Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Kyobu Geka. 2020 Apr;73(4):274-279.
In Japan, robot-assisted surgery for malignant lung tumors, benign mediastinal tumors, and malignant mediastinal tumors has been covered by the national health insurance since 2018. Hence, the number of domestic robotic surgical procedures is increasing. Recently, we introduced endoscopic surgery such as video-assisted thoracoscopic surgery (VATS) via a subxiphoidal approach for thymectomy. Here, we compared VATS and robotic surgery via a subxiphoidal approach in terms of clinical factors. During the study period, 5 consecutive patients who underwent robotic thymectomy and 24 patients who underwent VATS were analyzed. Although the operative time was longer in the robotic group, the intraoperative blood loss, postoperative length of stay, and postoperative complications were favorable in the robotic group. The disadvantage of robotic surgery is the necessity for a reduction in operative time including console duration time. However, future developments in the field of robotic engineering will lead to the creation of systems that allow for more advanced surgical techniques. We must chose procedures in consideration of the best method for each patient, and it is necessary to perform robotic surgery based on the expense and therapeutic effect, social environment, and way of life of each patient.
在日本，自2018年起，国家医疗保险已涵盖针对恶性肺肿瘤、良性纵隔肿瘤和恶性纵隔肿瘤的机器人辅助手术。因此，国内机器人手术的数量正在增加。最近，我们引入了内镜手术，如通过剑突下途径进行电视辅助胸腔镜手术（VATS）以行胸腺切除术。在此，我们从临床因素方面比较了剑突下途径的VATS和机器人手术。在研究期间，对连续5例行机器人胸腺切除术的患者和24例行VATS的患者进行了分析。虽然机器人组的手术时间较长，但机器人组的术中出血量、术后住院时间和术后并发症情况较好。机器人手术的缺点是需要缩短手术时间，包括控制台操作时间。然而，机器人工程领域的未来发展将带来能够实现更先进手术技术的系统。我们必须根据每位患者的最佳方法来选择手术方式，并且有必要基于每位患者的费用、治疗效果、社会环境和生活方式来进行机器人手术。
