Jian Zheng, Li Chengqiang, Feng Xijia, Yin Zhengxin, Han Yichao, Zhang Yajie, Han Dingpei, Xiang Jie, Li Hecheng
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Thorac Dis. 2022 May;14(5):1441-1449. doi: 10.21037/jtd-21-1895.
Combined anatomic subsegmentectomy performed by video-assisted thoracic surgery or robot-assisted thoracic surgery is an emerging minimally invasive surgical technique for patients with early-stage non-small cell lung cancer (NSCLC). However, the early results of these two methods have barely been studied.
A retrospective analysis of medical records from Shanghai Ruijin Hospital between July 2017 and August 2021 included 62 patients, 32 of whom underwent video-assisted combined anatomic pulmonary subsegmentectomy and 30 underwent robot-assisted combined anatomic pulmonary subsegmentectomy. Perioperative outcomes were compared.
Sixty-two patients with comparable baseline characteristics were included in this study. No significant difference was found in the length of postoperative hospital stay, operation duration, intraoperative blood loss and the rate of overall complications between the robot-assisted and video-assisted groups. A higher cost was observed in the robot-assisted group compared to the video-assisted group. There were more N1 lymph nodes and N1 stations dissected in the robot-assisted group compared with the video-assisted group; the same results were observed with regard to the number of N2 lymph nodes and N2 stations dissected.
It is safe and feasible for the patients with early-stage NSCLC to be treated with combined anatomic subsegmentectomy performed via robot-assisted or video-assisted thoracic surgery. The robotic approach may contribute to the potential improvements in N1 and N2 lymph node retrieval.
电视辅助胸腔镜手术或机器人辅助胸腔镜手术进行的联合解剖亚段切除术是一种用于早期非小细胞肺癌(NSCLC)患者的新兴微创手术技术。然而,这两种方法的早期结果几乎未被研究。
对上海瑞金医院2017年7月至2021年8月的病历进行回顾性分析,纳入62例患者,其中32例行电视辅助联合解剖性肺亚段切除术,30例行机器人辅助联合解剖性肺亚段切除术。比较围手术期结果。
本研究纳入了62例基线特征可比的患者。机器人辅助组和电视辅助组在术后住院时间、手术时长、术中出血量和总体并发症发生率方面未发现显著差异。与电视辅助组相比,机器人辅助组的费用更高。机器人辅助组切除的N1淋巴结和N1站比电视辅助组更多;在切除的N2淋巴结数量和N2站方面也观察到相同的结果。
对于早期NSCLC患者,通过机器人辅助或电视辅助胸腔镜手术进行联合解剖亚段切除术是安全可行的。机器人手术方法可能有助于在N1和N2淋巴结清扫方面取得潜在的改善。