Aoshima Hiroe, Omata Motoka, Shidei Hiroaki, Ogihara Akira, Mitsuboshi Shota, Isaka Tamami, Matsumoto Takako, Kanzaki Masato
The Department of Thoracic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
BMC Surg. 2025 Mar 26;25(1):115. doi: 10.1186/s12893-025-02843-7.
Mediastinal tumors (MTs) develop in various sites within the thoracic cavity, and the robotic surgical approach for MTs varies depending on the tumor location. This study aimed to assess the optimal approach for robotic surgery for MTs.
From April 2012 to May 2023, 141 cases of MTs removed by robotic surgery were noted. Of these, 130 cases, excluding those with combined lung resection, combined chest wall resection, and biopsy, were investigated for the MT location, surgical approach, operative time, and console time.
Of the participants, 61 were male and 69 were female, with a median age of 60 (16-85) years and a median tumor diameter of 23 (2.5-150) mm. Additionally, 5 upper MTs, 99 anterior MTs, 22 middle MTs, and 4 posterior MTs were observed. The median operative and console time was 146 (38-371) and 76 (14-239) min, respectively. All cases, except for one case of the upper and middle MTs, were operated in the lateral position via a lateral approach. Of the 99 anterior MTs, 87, 9, and 3 were operated via lateral approach, subxiphoid approach, and single incision, respectively. Of the 87 patients who underwent the lateral approach, 78 and 12 underwent surgery in the 30° lateral decubitus position and lateral positions, respectively.
Standardizing the robotic surgery approach for MTs on the basis of tumor location enhances procedural safety and feasibility.
纵隔肿瘤（MTs）发生于胸腔内的不同部位，针对MTs的机器人手术方法因肿瘤位置而异。本研究旨在评估MTs机器人手术的最佳方法。
记录2012年4月至2023年5月期间通过机器人手术切除的141例MTs病例。其中，排除合并肺切除、合并胸壁切除及活检的病例后，对130例病例的MT位置、手术方法、手术时间及控制台操作时间进行调查。
参与者中，男性61例，女性69例，中位年龄为60（16 - 85）岁，中位肿瘤直径为23（2.5 - 150）mm。此外，观察到5例上纵隔肿瘤、99例前纵隔肿瘤、22例中纵隔肿瘤和4例后纵隔肿瘤。中位手术时间和控制台操作时间分别为146（38 - 371）分钟和76（14 - 239）分钟。除1例上纵隔和中纵隔肿瘤外，所有病例均通过外侧入路在侧卧位进行手术。在99例前纵隔肿瘤中，分别有87例、9例和3例通过外侧入路、剑突下入路和单切口进行手术。在87例行外侧入路的患者中，分别有78例和12例在30°侧卧位和侧位进行手术。
根据肿瘤位置规范MTs的机器人手术方法可提高手术安全性和可行性。
