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机器人辅助胸壁切除术治疗原发性良性胸壁肿瘤和局部晚期肺癌:一项机构病例系列研究及全国报告

Robotic chest wall resection for primary benign chest wall tumors and locally advanced lung cancer: an institutional case series and national report.

作者信息

Verm Raymond A, Vigneswaran Wickii T, Lin Andrew, Zywiciel Joseph, Freeman Richard, Abdelsattar Zaid M

机构信息

Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA.

Department of Surgery, Edward Hines VA Medical Center, Hines, IL, USA.

出版信息

J Thorac Dis. 2023 Sep 28;15(9):4849-4858. doi: 10.21037/jtd-23-532. Epub 2023 Aug 31.

Abstract

BACKGROUND

Limited data exists for robotic chest wall resection; we report institutional and national experience of robotic chest wall resection.

METHODS

In this comparative retrospective case series we describe patients who underwent robotic chest wall resection at our institution and enrich this case series with data from the National Cancer Database (NCDB). We describe our preoperative workup, operative technique, and postoperative care. Outcomes included conversion to open, length of stay, readmissions, and 30- and 90-day mortality. The results are descriptively reported and compared.

RESULTS

We describe 6 patients institutionally and 96 NCDB patients. At our institution 66.7% were males, median age was 70.0 (range, 39-91) years, and 50% were primary chest wall tumors. Median tumor size was 5.25 (range, 2.3-8.3) cm. Outcomes were as follows: no open conversions, median length of stay 3 (range, 1-6) days, no unplanned 30-day readmissions or 90-day mortality. In the NCDB, 55.2% were males with median age of 68.5 (range, 30-89) years. Median tumor size was 3.90 (range, 2.4-6.0) cm. NCDB outcomes were as follows: 18.8% open conversion, median length of stay 7 (range, 5-10) days, 3.1% unplanned 30-day readmission, and 8.3% 90-day mortality. Our institutional case series had 18.0 months median follow-up (range, 6-54 months) with no functional deficits. Median survival in NCDB was 49.6 months.

CONCLUSIONS

Robotic chest wall resection is feasible and is performed nationally with acceptable short- and long-term outcomes. Our institutional experience reports our technique, resultant short hospital stay, and excellent functional outcomes.

摘要

背景

关于机器人辅助胸壁切除术的数据有限;我们报告了机构和全国范围内机器人辅助胸壁切除术的经验。

方法

在这个比较性回顾性病例系列中我们描述了在本机构接受机器人辅助胸壁切除术的患者,并通过国家癌症数据库(NCDB)的数据丰富了这个病例系列。我们描述了术前检查、手术技术和术后护理。结果包括转为开放手术、住院时间、再入院情况以及30天和90天死亡率。对结果进行描述性报告并比较。

结果

我们描述了本机构的6例患者以及NCDB中的96例患者。在本机构,66.7%为男性,中位年龄为70.0(范围39 - 91)岁,50%为原发性胸壁肿瘤。肿瘤中位大小为5.25(范围2.3 - 8.3)厘米。结果如下:无转为开放手术的情况,中位住院时间为3(范围1 - 6)天,无计划外30天再入院或90天死亡率。在NCDB中,5又5.2%为男性,中位年龄为68.5(范围30 - 89)岁。肿瘤中位大小为3.90(范围2.4 - 6.0)厘米。NCDB的结果如下:18.8%转为开放手术,中位住院时间为7(范围5 - 10)天,3.1%计划外30天再入院,8.3% 90天死亡率。我们机构的病例系列中位随访时间为18.0个月(范围6 - 54个月),无功能缺陷。NCDB中的中位生存期为49.6个月。

结论

机器人辅助胸壁切除术是可行的,在全国范围内开展,短期和长期结果均可接受。我们机构的经验报告了我们的技术、由此带来的短住院时间以及良好的功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8c/10586962/dbadc60f8565/jtd-15-09-4849-vid1.jpg

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