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马里兰镊与电凝钩在达芬奇机器人辅助胸腔镜纵隔肿瘤切除术中的疗效比较。

Efficacy of using Maryland forceps versus electrocoagulation hooks in da Vinci robot-assisted thoracoscopic mediastinal tumor resection.

机构信息

The First Clinical Medical College of Gansu University of Chinese Medicine, Gansu Provincial Hospital, Lanzhou, China.

Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China.

出版信息

World J Surg Oncol. 2023 Jun 19;21(1):184. doi: 10.1186/s12957-023-03065-y.

Abstract

BACKGROUND

To compare the difference of short-term curative effect between the use of Maryland forceps (MF) and electrocoagulation hooks (EH) in da Vinci robot-assisted thoracoscopic mediastinal tumor resection.

METHODS

Retrospectively analyze 84 patients with mediastinal tumors who underwent robot-assisted thoracoscopic surgery (RATS) at the Department of Thoracic Surgery in Gansu Provincial Hospital from February 2019 to February 2023. Two groups were divided according to the intraoperative use of energy devices, including 41 cases in the MF group and 43 cases in the EH group. Perioperative clinical data was gathered to compare the short-term efficacy of patients in both groups.

RESULTS

There were no significant differences in baseline characteristics such as sex (P = 0.685), age (P = 0.165), and tumor size (P = 0.339) between the two groups. Compared with the EH group, patients in the MF group have shorter operative time (P = 0.030), less intraoperative bleeding (P = 0.010), less total postoperative drainage volume (P = 0.001), shorter postoperative drainage time (P = 0.022), shorter hospital stay (P = 0.019), and lower levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), and cortisol. No statistically significant differences were found between the two groups in terms of total hospitalization costs (P = 0.123), postoperative visual analog scale (VAS) pain scores (P = 0.064), and postoperative complications (P = 0.431).

CONCLUSION

Using MF in RATS for mediastinal tumor is safe and effective, which can reduce the amount of bleeding, reduce the degree of inflammatory reaction, and conducive to the quick recovery of patients.

摘要

背景

比较 Maryland 钳(MF)和电钩(EH)在达芬奇机器人辅助胸腔纵隔肿瘤切除术中短期疗效的差异。

方法

回顾性分析 2019 年 2 月至 2023 年 2 月甘肃省人民医院胸外科行达芬奇机器人辅助胸腔镜手术(RATS)的 84 例纵隔肿瘤患者。根据术中使用能量器械的不同,将患者分为 MF 组(n=41)和 EH 组(n=43)。收集围手术期临床资料,比较两组患者的短期疗效。

结果

两组患者在性别(P=0.685)、年龄(P=0.165)和肿瘤大小(P=0.339)等基线特征方面无显著差异。与 EH 组相比,MF 组患者的手术时间更短(P=0.030)、术中出血量更少(P=0.010)、总术后引流量更少(P=0.001)、术后引流时间更短(P=0.022)、住院时间更短(P=0.019)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和皮质醇水平更低。两组患者的总住院费用(P=0.123)、术后视觉模拟评分(VAS)疼痛评分(P=0.064)和术后并发症发生率(P=0.431)差异无统计学意义。

结论

在 RATS 中使用 MF 治疗纵隔肿瘤安全有效,可减少出血,降低炎症反应程度,有利于患者快速康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712c/10280858/9189e1a50df7/12957_2023_3065_Fig1_HTML.jpg

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