10604 Department of Thoracic Surgery, Orlando Health Cancer Institute, FL, USA.
25105 Department of General Surgery, Orlando Regional Medical Center, FL, USA.
Innovations (Phila). 2021 Sep-Oct;16(5):441-447. doi: 10.1177/15569845211030917. Epub 2021 Aug 5.
Clinical adoption of robotic lobectomy for management of lung cancer is rapidly increasing across the world. Several studies have evaluated the technique with regards to perioperative and cost outcomes, with evidence beginning to grow regarding long-term oncologic outcomes. We report perioperative and oncologic outcomes in our single institution experience with 500 consecutive robotic lobectomies, including a significant portion for locally advanced disease.
This study is a retrospective review of the first 500 robotic lobectomies performed at our institution from 2010 to 2018. Segmentectomy, pneumonectomy, and lobectomy for other conditions were excluded. Descriptive statistics and Kaplan-Meier survival analysis are presented.
Pathologic stage distribution was IA in 194 (39%), IB in 54 (11%), IIA in 41 (8%), IIB in 109 (22%), IIIA in 83 (17%), IIIB in 11 (2%), and IV in 8 (2%). Elective conversion occurred in 26 cases (5.2%) and emergent conversion occurred in 3 cases (0.6%). Mean length of stay was 3.7 days (1 to 40). The most common complications encountered were atrial fibrillation in 71 (14.2%) and prolonged air leak in 49 (9.8%). Thirty-day mortality occurred in 3 patients (0.6%). Nodal upstaging was 16.6%. Stage specific overall survival outcomes included an 84% survival for stage IA patients, 73% for IB, 68% for IIA, 63% for IIB, and 49% for IIIA disease.
Robotic lobectomy for lung cancer is a feasible technique for treatment of non-small cell lung cancer with low perioperative morbidity and mortality. Furthermore, excellent oncologic outcomes can be achieved with this approach.
在全球范围内，采用机器人辅助肺叶切除术治疗肺癌的临床应用正在迅速增加。有几项研究评估了该技术的围手术期和成本结果，并且关于长期肿瘤学结果的证据也在不断增加。我们报告了我们在单机构的 500 例连续机器人肺叶切除术的围手术期和肿瘤学结果，其中包括相当一部分局部晚期疾病。
这是对我们机构 2010 年至 2018 年间进行的前 500 例机器人肺叶切除术的回顾性研究。排除了节段切除术、全肺切除术和因其他原因进行的肺叶切除术。本研究采用描述性统计学和 Kaplan-Meier 生存分析。
病理分期分布为 IA 期 194 例（39%），IB 期 54 例（11%），IIA 期 41 例（8%），IIB 期 109 例（22%），IIIA 期 83 例（17%），IIIB 期 11 例（2%），IV 期 8 例（2%）。择期转换发生 26 例（5.2%），紧急转换发生 3 例（0.6%）。平均住院时间为 3.7 天（1 至 40 天）。最常见的并发症为心房颤动 71 例（14.2%）和持续性肺漏气 49 例（9.8%）。30 天死亡率为 3 例（0.6%）。淋巴结分期升级为 16.6%。特定分期的总生存结果包括 IA 期患者的 84%生存率、IB 期的 73%、IIA 期的 68%、IIB 期的 63%和 IIIA 期的 49%。
机器人辅助肺叶切除术治疗非小细胞肺癌是一种可行的技术，具有较低的围手术期发病率和死亡率。此外，这种方法可以获得优异的肿瘤学结果。
