Şengül İnan Merve, Kavaklı Kuthan, Işık Hakan, Sapmaz Ersin, Gürkök Sedat, İlhan Sezer Elif, Çaylak Hasan, Genç Onur
Department of Thoracic Surgery, Gülhane Training and Research Hospital, Ankara, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Apr 28;31(2):215-221. doi: 10.5606/tgkdc.dergisi.2023.23283. eCollection 2023 Apr.
This study aims to evaluate the feasibility, safety, and efficacy of transthoracic robot-assisted surgery for diaphragmatic plication and to describe our surgical approach in detail.
Between January 2014 and January 2020, a total of 13 patients (11 males, 2 females; median age: 55 years; range, 24 to 70 years) who underwent diaphragmatic plication with the robotic system were retrospectively analyzed. The changes in the Medical Research Council dyspnea scale, forced expiratory volume in 1 sec, body mass index, and quality of life scale scores of the patients before the operation and at the first year of follow-up were examined.
Twelve of the operations were performed on the left side. The median pre- and postoperative Medical Research Council dyspnea scores were 2 (range, 1 to 4) and 1 (range, 1 to 4), respectively, indicating a statistically significant improvement (p=0.008). A significant improvement was detected in the forced expiratory volume in 1 sec of the patients in the first year after surgery (p=0.036). In terms of quality of life parameters, only, in the physical health subscale, the scores were statistically significantly different in the pre- and postoperative first-year follow-up (p=0.002). Median time to chest tube removal was 1 (range 1-5, IQR=0,5) days. Median total length of hospital stay was 2 (range 2-18, IQR=3) days.
Owing to its technical dexterity, the robot enables the plication to be performed easily and safely. Late improvement in respiratory functions is reflected in quality of life.
本研究旨在评估经胸机器人辅助膈折叠术的可行性、安全性和有效性，并详细描述我们的手术方法。
回顾性分析2014年1月至2020年1月期间共13例（11例男性，2例女性；中位年龄：55岁；范围24至70岁）接受机器人系统膈折叠术的患者。检查患者术前及随访第1年时医学研究委员会呼吸困难量表、第1秒用力呼气量、体重指数和生活质量量表评分的变化。
12例手术在左侧进行。术前和术后医学研究委员会呼吸困难评分中位数分别为2分（范围1至4分）和1分（范围1至4分），表明有统计学意义的改善（p=0.008）。术后第1年患者的第1秒用力呼气量有显著改善（p=0.036）。在生活质量参数方面，仅在身体健康子量表中，术前和术后第1年随访时的评分有统计学显著差异（p=0.002）。胸管拔除的中位时间为1天（范围1至5天，四分位距=0.5天）。住院总时长中位数为2天（范围2至18天，四分位距=3天）。
由于其技术灵活性，机器人使膈折叠术能够轻松、安全地进行。呼吸功能的后期改善反映在生活质量上。
