Cheng Kuang-I, Tse Jockey, Li Tzu-Ying
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
J Pers Med. 2022 Jan 5;12(1):52. doi: 10.3390/jpm12010052.
In 2000, the da Vinci Surgery System was approved by the United States Food and Drug Administration for general laparoscopic surgery and it became the first commercially available robotic surgery system. The aim of this study was to identify the incidence of postoperative pulmonary complications (PPCs) in patients undergoing da Vinci surgery and to observe whether the incidence of PPCs was affected by the usage of Sugammadex. Sugammadex is a gamma-cyclodextrin that encapsulates and subsequently inactivates steroidal neuromuscular blocking agents. A retrospective study was conducted on patients who had undergone da Vinci surgery in a single medical center in southern Taiwan during the period from January 2018 to December 2018. We extracted data on patient characteristics, usage of Sugammadex and PPCs for analysis. Three hundred and thirty-three patients were enrolled in the final analysis. While the overall incidence of PPCs was 30.3% (101/333 patients), the incidence of PCC in patients who received Sugammadex (24.2%) was significantly lower than those without (37.3%) ( = 0.001). Risk factors that appeared to be closely associated with PCC included age, malignancy, hypertension, chronic kidney disease, blood loss amount and anemia. The use of Sugammadex decreased the risk of PPC. In order to enhance early recovery after da Vinci surgery, the use of Sugammadex to rapidly reverse muscle relaxants may be an appropriate choice.
2000年，达芬奇手术系统获得美国食品药品监督管理局批准用于普通腹腔镜手术，成为首个可商业化的机器人手术系统。本研究旨在确定接受达芬奇手术患者术后肺部并发症（PPCs）的发生率，并观察PPCs的发生率是否受舒更葡糖钠使用情况的影响。舒更葡糖钠是一种γ-环糊精，可包裹甾体类神经肌肉阻滞剂并使其失活。对2018年1月至2018年12月期间在台湾南部一家医疗中心接受达芬奇手术的患者进行了一项回顾性研究。我们提取了患者特征、舒更葡糖钠使用情况和PPCs的数据进行分析。最终纳入333例患者进行分析。PPCs的总体发生率为30.3%（101/333例患者），接受舒更葡糖钠治疗的患者中PCC的发生率（24.2%）显著低于未接受治疗的患者（37.3%）（P = 0.00）。似乎与PCC密切相关的危险因素包括年龄、恶性肿瘤、高血压、慢性肾脏病、失血量和贫血。舒更葡糖钠的使用降低了PPC的风险。为了促进达芬奇手术后的早期恢复，使用舒更葡糖钠快速逆转肌肉松弛剂可能是一个合适的选择。
