Background: Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer.
Methods: 45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared.
Results: No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes.
Conclusions: RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.
背景与目的 作为20世纪最伟大发明之一的达芬奇机器人手术系统代表了精准微创外科的发展方向，本文旨在比较达芬奇机器人与电视胸腔镜辅助肺癌根治术的近期疗效。方法 回顾性分析自2014年1月-2017年1月在我院行达芬奇机器人手术以及行电视胸腔镜辅助手术治疗非小细胞肺癌患者的相关临床资料，两组各纳入45例并进行配对的病例对照研究。比较两组的手术时间、术中失血量、术中淋巴结清扫数量、淋巴结清扫站数、术后带管时间、术后住院天数、术后第1日胸引液的量以及术后胸引液的总量。结果 两组均无中转开胸及围术期死亡病例。机器人组与胸腔镜组的术中失血量[（50.30±32.33）mL vs（208.60±132.63）mL]与术后第1日胸引液的量[（275.00±145.42）mL vs（347.60±125.80）mL]比较，机器人组均少于胸腔镜组；机器人组与胸腔镜组的淋巴结清扫数量[（22.67±9.67）个 vs（15.51±5.41）个]及淋巴结清扫站数[（6.31±1.43）站 vs （4.91±1.04）站]比较，机器人组均多于胸腔镜组，差异具有统计学意义；两组的其他指标比较，差异均无统计学意义。结论 达芬奇机器人行非小细胞肺癌根治术安全、有效，在近期术后疗效上优于胸腔镜组。.
Keywords: Lung neoplsms; Matching case-control study; Robot-assisted thoracic surgery; Short-term outcomes; Video-assisted thoracic surgery.