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机器人辅助胸腔镜手术治疗后纵隔神经源性肿瘤的临床疗效

Clinical efficacy of robot-assisted thoracoscopic surgery for posterior mediastinal neurogenic tumors.

作者信息

Li Xiao-Kun, Cong Zhuang-Zhuang, Xu Yang, Zhou Hai, Wu Wen-Jie, Wang Gao-Ming, Qiang Yong, Shen Yi

机构信息

Department of Cardiothoracic Surgery, Jingling Hospital, School of Medicine, Southeast University, Nanjing, China.

Department of Cardiothoracic Surgery, Jingling Hospital, Medical School of Nanjing University, Nanjing, China.

出版信息

J Thorac Dis. 2020 Jun;12(6):3065-3072. doi: 10.21037/jtd-20-286.

Abstract

BACKGROUND

Robot-assisted thoracic surgery (RATS) has an increasing usage throughout the world. This retrospective cohort study aimed to objectively compare the surgical results between video-assisted thoracic surgery (VATS) and RATS in posterior mediastinal neurogenic tumors (PMNT).

METHODS

We retrospectively reviewed the clinical data of 130 patients diagnosed with posterior mediastinal neurogenic tumor between 2015 and 2018. Magnetic resonance imaging (MRI) or enhanced computed tomography scan (CT-scan) was used to locate the tumor and investigate the Adamkiewicz's artery preoperatively. The individual surgical approach was determined by both tumor size and patient's willings.

RESULTS

The surgical time in RATS (43.2±12.6 min) was tended to be less than that in VATS (47.4±11.9 min) (P=0.054). Meanwhile, the estimated blood loss in RATS group (85.8±22.6 mL) was significantly less than that in VATS group (95.3±28.4 mL) (P=0.040). However, the duration of chest tube (days) and volume of drainage (mL) had no significant difference between two groups (P=0.12 and P=0.68, respectively). The postoperative hospital stay (days) of patients in RATS group (2.2±0.4 days) was significantly shorter than that in VATS group (2.4±0.6 days) (P=0.031). There were no significant differences between two groups in the incidence of the postoperative complications and adverse reactions.

CONCLUSIONS

RATS has the superiorities in terms of surgical blood loss and postoperative hospital stay over VATS for posterior mediastinal neurogenic tumor. In conclusion, RATS could be a feasible and safe way for resecting posterior mediastinal neurogenic tumor.

摘要

背景

机器人辅助胸外科手术(RATS)在全球的应用日益广泛。这项回顾性队列研究旨在客观比较电视辅助胸外科手术(VATS)和RATS治疗后纵隔神经源性肿瘤(PMNT)的手术结果。

方法

我们回顾性分析了2015年至2018年间130例诊断为后纵隔神经源性肿瘤患者的临床资料。术前采用磁共振成像(MRI)或增强计算机断层扫描(CT扫描)定位肿瘤并探查Adamkiewicz动脉。根据肿瘤大小和患者意愿确定个体化手术方式。

结果

RATS组的手术时间(43.2±12.6分钟)倾向于短于VATS组(47.4±11.9分钟)(P=0.054)。同时,RATS组估计失血量(85.8±22.6毫升)显著少于VATS组(95.3±28.4毫升)(P=0.040)。然而,两组胸腔引流管留置时间(天)和引流量(毫升)无显著差异(分别为P=0.12和P=0.68)。RATS组患者术后住院时间(2.2±0.4天)显著短于VATS组(2.4±0.6天)(P=0.031)。两组术后并发症和不良反应发生率无显著差异。

结论

对于后纵隔神经源性肿瘤,RATS在手术失血量和术后住院时间方面优于VATS。总之,RATS可能是切除后纵隔神经源性肿瘤的一种可行且安全的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94dd/7330773/3a5f5c1dd397/jtd-12-06-3065-f1.jpg

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