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机器人辅助肺叶切除术与完全门静脉机器人肺叶切除术:有何区别?

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

作者信息

Akkuş Murat, Seyrek Yunus

机构信息

Department of Thoracic Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):648-655. doi: 10.5606/tgkdc.dergisi.2020.19436. eCollection 2020 Oct.

Abstract

BACKGROUND

This study aims to compare robot-assisted lobectomy versus completely portal robotic lobectomy.

METHODS

Between January 2014 and December 2019, a total of 41 patients (10 males, 31 females; median age 62 years; range, 50 to 68 years) underwent robotic anatomical pulmonary resection in our institution were retrospectively analyzed. The patients were consecutively divided into two groups: the first 20 (48.8%) patients underwent pulmonary resection by robot-assisted lobectomy technique, while the next 21 (51.2%) patients underwent pulmonary resection by completely portal robotic lobectomy with four arms. Data including age, sex, diagnosis, surgery type and duration, rate of conversion to open surgery, and length of stay of the patients were recorded. The operation time, docking time, console time, and closure duration for each patient were also noted.

RESULTS

There was no statistically significant difference in age, sex, comorbidities, complications, length of hospital stay, adequate lymph node staging, or tumor size and side between the two groups (p>0.05). However, the mean console and operation times were statistically significantly shorter in the patients receiving completely portal robotic lobectomy with four arms (p=0.001).

CONCLUSION

The advantage of completely portal robotic lobectomy with four arms is relative, although it significantly shortens the operation time. Based on our experiences, this technique may be preferred in case of inadequate lung deflation, as carbon dioxide insufflation allows sufficient workspace for robotic lung resection.

摘要

背景

本研究旨在比较机器人辅助肺叶切除术与完全腹腔镜机器人肺叶切除术。

方法

回顾性分析2014年1月至2019年12月期间在我院接受机器人解剖性肺切除术的41例患者(男性10例,女性31例;中位年龄62岁;范围50至68岁)。患者连续分为两组:前20例(48.8%)患者采用机器人辅助肺叶切除术技术进行肺切除术,而后21例(51.2%)患者采用四臂完全腹腔镜机器人肺叶切除术进行肺切除术。记录患者的年龄、性别、诊断、手术类型和持续时间、转为开放手术的比例以及住院时间。还记录了每位患者的手术时间、对接时间、控制台操作时间和关闭时间。

结果

两组患者在年龄、性别、合并症、并发症、住院时间、充分的淋巴结分期、肿瘤大小和部位方面无统计学显著差异(p>0.05)。然而,接受四臂完全腹腔镜机器人肺叶切除术的患者的平均控制台操作时间和手术时间在统计学上显著缩短(p=0.001)。

结论

四臂完全腹腔镜机器人肺叶切除术的优势是相对的,尽管它显著缩短了手术时间。根据我们的经验,在肺膨胀不全的情况下,这种技术可能更受青睐,因为二氧化碳气腹可为机器人肺切除术提供足够的操作空间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c9f/7759039/0a73e9388c56/TJTCS-2020-28-4-648-655-F1.jpg

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