Department of Blood Transfusion, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fuma Road, Jin'an District, Fuzhou, China, 350014.
Fuding Panxi Health Center, No.68 Wenkui Road, Panxi Town, Ningde, 355213, China.
J Robot Surg. 2023 Dec;17(6):2773-2781. doi: 10.1007/s11701-023-01712-w. Epub 2023 Sep 15.
The objective is to compare the perioperative blood transfusion rate and postoperative complications between robot-assisted surgery and thoracoscopic surgery in lung cancer patients. This is a single-center retrospective study. Patients underwent lung cancer minimally invasive resection at Fujian Cancer Hospital from April 1, 2022, to April 30, 2023, were enrolled in this study. Patients were divided into robotic-assisted lobectomy (RAL) and video-assisted lobectomy (VAL) groups according to the surgical methods. Data, including demographics, clinic variables, and endpoint outcomes were collected from the electronic medical record. Propensity score matching (PSM) was performed to analyze the baseline data of patients. The RAL group and the VAL group were matched 1:1. Then, the blood transfusion rates and short-term outcomes of the two groups were compared. A logistic regression was performed to analyze the independent risk factors of perioperative blood transfusion. A total of 558 patients were enrolled in this study. 166 of 558 patients were divided into the RAL group, and 392 patients were into the VAL group. A total of 118 patients were selected and analyzed following propensity score matching. After PSM, there was no difference in perioperative transfusion rates, including RBC transfusion and frozen plasma transfusion, between the VAL and RAL groups (P > 0.05). The RAL group had fewer days of drainage tubes (P = 0.036). There was no difference in other short-term outcomes, including the volume of thoracic drainage, the volume of intraoperative blood loss, the length of hospitalization, and the rate of postoperative pulmonary infection (P > 0.05). Volume of intraoperative blood loss, volume of thoracic drainage, and preoperative hemoglobin were independent risk factors of perioperative red blood cell or frozen plasma transfusion; however, RAL or VAL was not. The study showed that the rates of perioperative blood transfusion were comparable between RAL and VAL. RAL is superior for patient recovery in terms of short-term outcomes.
比较机器人辅助手术与电视胸腔镜手术治疗肺癌患者的围手术期输血率和术后并发症。这是一项单中心回顾性研究。本研究纳入了 2022 年 4 月 1 日至 2023 年 4 月 30 日在福建省肿瘤医院接受肺癌微创切除术的患者。根据手术方式将患者分为机器人辅助肺叶切除术（RAL）组和电视胸腔镜辅助肺叶切除术（VAL）组。从电子病历中收集患者的人口统计学、临床变量和终点结局数据。采用倾向评分匹配（PSM）分析患者的基线数据。RAL 组和 VAL 组按 1:1 匹配。然后比较两组的输血率和短期结局。采用 logistic 回归分析围手术期输血的独立危险因素。共纳入 558 例患者，其中 166 例患者分为 RAL 组，392 例患者分为 VAL 组。共选择 118 例患者进行倾向评分匹配分析。PSM 后，VAL 组和 RAL 组围手术期输血率（包括红细胞输血和冰冻血浆输血）差异无统计学意义（P>0.05）。RAL 组引流管留置时间较短（P=0.036）。其他短期结局差异无统计学意义，包括胸腔引流量、术中出血量、住院时间和术后肺部感染发生率（P>0.05）。术中出血量、胸腔引流量和术前血红蛋白是围手术期红细胞或冰冻血浆输血的独立危险因素，但 RAL 或 VAL 不是。该研究表明，RAL 和 VAL 治疗肺癌患者的围手术期输血率相当。RAL 在短期结局方面更有利于患者恢复。
