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机器人辅助胸腔镜手术治疗炎症性和感染性肺部疾病:巴西的初步经验。

Robotic thoracic surgery for inflammatory and infectious lung disease: initial experience in Brazil.

作者信息

Leite Pedro Henrique Cunha, Mariani Alessandro Wasum, Araujo Pedro Henrique Xavier Nabuco DE, Lima Carlos Eduardo Teixeira, Braga Felipe, Haddad Rui, Campos José Ribas Milanez DE, Pego-Fernandes Paulo Manuel, Terra Ricardo Mingarini

机构信息

- Hospital São Rafael, Serviço de Cirurgia Torácica - Salvador - BA - Brasil.

- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, Departamento de Cirurgia Torácica - São Paulo - SP - Brasil.

出版信息

Rev Col Bras Cir. 2021 May 17;48:e20202872. doi: 10.1590/0100-6991e-20202872. eCollection 2021.

Abstract

OBJECTIVE

in Latin America, especially Brazil, the use of a robotic platform for thoracic surgery is gradually increasing in recent years. However, despite tuberculosis and inflammatory pulmonary diseases are endemic in our country, there is a lack of studies describing the results of robotic surgical treatment of bronchiectasis. This study aims to evaluate the surgical outcomes of robotic surgery for inflammatory and infective diseases by determining the extent of resection, postoperative complications, operative time, and length of hospital stay.

METHODS

retrospective study from a database involving patients diagnosed with bronchiectasis and undergoing robotic thoracic surgery at three hospitals in Brazil between January of 2017 and January of 2020.

RESULTS

a total of 7 patients were included. The mean age was 47 + 18.3 years (range, 18-70 years). Most patients had non-cystic fibrosis bronchiectasis (n=5), followed by tuberculosis bronchiectasis (n=1) and lung abscess (n=1). The performed surgeries were lobectomy (n=3), anatomic segmentectomy (n=3), and bilobectomy (n=1). The median console time was 147 minutes (range 61-288 min.) and there was no need for conversion to open thoracotomy. There were no major complications. Postoperative complications occurred in one patient and it was a case of constipation with the need for an intestinal lavage. The median for chest tube time and hospital stay, in days, was 1 (range, 1-6 days) and 5 (range, 2-14 days) respectively.

CONCLUSIONS

robotic thoracic surgery for inflammatory and infective diseases is a feasible and safe procedure, with a low risk of complications and morbidity.

摘要

目的

在拉丁美洲,尤其是巴西,近年来用于胸外科手术的机器人平台的使用正在逐渐增加。然而,尽管我国结核病和炎性肺部疾病呈地方流行,但缺乏描述机器人手术治疗支气管扩张症结果的研究。本研究旨在通过确定切除范围、术后并发症、手术时间和住院时间来评估机器人手术治疗炎性和感染性疾病的手术效果。

方法

对一个数据库进行回顾性研究,该数据库涉及2017年1月至2020年1月期间在巴西三家医院被诊断为支气管扩张症并接受机器人胸外科手术的患者。

结果

共纳入7例患者。平均年龄为47±18.3岁(范围18 - 70岁)。大多数患者患有非囊性纤维化支气管扩张症(n = 5),其次是结核性支气管扩张症(n = 1)和肺脓肿(n = 1)。所进行的手术包括肺叶切除术(n = 3)、解剖性肺段切除术(n = 3)和双肺叶切除术(n = 1)。中位控制台时间为147分钟(范围61 - 288分钟),无需转为开胸手术。无重大并发症。1例患者出现术后并发症,为便秘,需要进行肠道灌洗。胸管留置时间和住院天数的中位数分别为1天(范围1 - 6天)和5天(范围2 - 14天)。

结论

机器人胸外科手术治疗炎性和感染性疾病是一种可行且安全的手术方法,并发症和发病率风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a05/10683415/02570f745504/rcbc-48-e20202872-g001.jpg

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