Goto Hidenori, Nakanishi Kozo
Department of General Thoracic Surgery, National Hospital Organization, Saitama Hospital, Wako, Saitama, Japan.
J Thorac Dis. 2025 May 30;17(5):3147-3156. doi: 10.21037/jtd-2025-73. Epub 2025 May 26.
In Japan, clinical engineers (CEs) have been permitted to operate endoscopic video cameras in endoscopic surgery since October 2021. The current study aimed to evaluate the perioperative outcomes of uniportal video-assisted thoracoscopic surgery (UVATS) lobectomy in scope operation performed by a CE.
Consecutive patients who underwent lobectomy between January 2020 and December 2024 were retrospectively reviewed. The perioperative outcomes of UVATS lobectomy in scope operation conducted by surgeons [the doctor (DR) group] were compared with those of UVATS lobectomy in scope operation performed by CEs (the CE group). The perioperative outcomes between the DR and CE groups were compared using propensity-score matching.
In total, 71 and 77 patients in the CE and DR groups, respectively, underwent UVATS lobectomy. After propensity-score matching, the data of 46 patients from each of the two groups were retrieved. The two groups did not significantly differ in terms of surgical duration, intraoperative blood loss volume, rate of conversion to multiportal VATS lobectomy or thoracotomy, postoperative morbidity, drain placement duration, and length of postoperative hospital stay. None of the patients in the two groups died.
The perioperative outcomes of UVATS lobectomy in scope operation conducted by CEs were comparable to those of UVATS lobectomy in scope operation performed by surgeons.
在日本,自2021年10月起,临床工程师(CE)被允许在内镜手术中操作内镜摄像机。本研究旨在评估由临床工程师进行的单孔电视辅助胸腔镜手术(UVATS)肺叶切除术中范围操作的围手术期结果。
回顾性分析2020年1月至2024年12月期间连续接受肺叶切除术的患者。将外科医生进行的UVATS肺叶切除术中范围操作的围手术期结果(医生组)与临床工程师进行的UVATS肺叶切除术中范围操作的围手术期结果(CE组)进行比较。使用倾向得分匹配法比较医生组和CE组之间的围手术期结果。
CE组和医生组分别有71例和77例患者接受了UVATS肺叶切除术。经过倾向得分匹配后,从两组中各检索出46例患者的数据。两组在手术时间、术中失血量、转为多孔VATS肺叶切除术或开胸手术的比例、术后发病率、引流管放置时间和术后住院时间方面无显著差异。两组患者均无死亡。
临床工程师进行的UVATS肺叶切除术中范围操作的围手术期结果与外科医生进行的UVATS肺叶切除术中范围操作的围手术期结果相当。