Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Thorac Cancer. 2023 Jun;14(16):1512-1519. doi: 10.1111/1759-7714.14895. Epub 2023 May 1.
To explore whether robotic lobectomy (RL) is superior to video-assisted lobectomy (VAL) in terms of short-term outcomes in patients with pulmonary neoplasms.
From January 30, 2019 to February 28, 2022, a series of consecutive minimally invasive lobectomies were performed for patients with pulmonary neoplasms. Perioperative outcomes such as operation time, blood loss, dissected lymph nodes (LNs), surgical complications, postoperative pain control, length of postoperative stay in hospital, and total cost of hospitalization were compared.
A total of 336 cases including 173 RLs and 163 VALs were enrolled. Baseline characteristics were comparable between groups. RLs were associated with shorter operation time (median [interquadrant range, IQR], 107 min [90-130] vs. 120 min [100-149], p < 0.001), less blood loss (median [IQR], 50 mL [30-60] vs. 50 mL [50-80], p = 0.02), and lower blood transfusion rate (3.5% vs. 9.8%, p = 0.02) compared with VALs. More LNs were harvested by the robotic approach (median [IQR], 29 [20-41] vs. 22 [15-45], p = 0.04). The incidences of conversion, major postoperative complications, extra analgesic usage, and postoperative length of stay were all comparable between the RL and VAL groups. As predicted, the total cost of hospitalization was greater in the RL group (median [IQR], $16728.35 [15682.16-17872.15] vs. $10713.47 [9662.13-11742.15], p < 0.001).
RL improved surgical efficacy with shortened operative time, less blood loss, and more thorough LN dissection compared with VAL, compromised by higher cost.
为了探究在肺部肿瘤患者的短期治疗效果方面，机器人肺叶切除术（RL）是否优于电视辅助肺叶切除术（VAL）。
自 2019 年 1 月 30 日至 2022 年 2 月 28 日，一系列连续的微创肺叶切除术被用于肺部肿瘤患者。比较了手术时间、出血量、解剖淋巴结（LNs）数量、手术并发症、术后疼痛控制、术后住院时间和总住院费用等围手术期结果。
共纳入 336 例患者，其中 RL 组 173 例，VAL 组 163 例。两组基线特征无差异。RL 组的手术时间更短（中位数[四分位距，IQR]，107 分钟[90-130]比 120 分钟[100-149]，p<0.001），出血量更少（中位数[IQR]，50 毫升[30-60]比 50 毫升[50-80]，p=0.02），输血率更低（3.5%比 9.8%，p=0.02）。机器人组采集的淋巴结更多（中位数[IQR]，29 [20-41]比 22 [15-45]，p=0.04）。RL 和 VAL 组的中转率、主要术后并发症、额外镇痛药使用和术后住院时间均无差异。正如预期的那样，RL 组的总住院费用更高（中位数[IQR]，$16728.35 [15682.16-17872.15]比$10713.47 [9662.13-11742.15]，p<0.001）。
RL 与 VAL 相比，手术时间更短，出血量更少，淋巴结清扫更彻底，但费用更高。
