气动臂辅助单人单孔胸腔镜手术的应用评价

Evaluation of the appfication of pneumatic arm assisted single surgeon uniportal thoracoscopic surgery

目的评价气动臂辅助单人单孔胸腔镜手术应用效果评价。方法统计2016年10月期间上海市肺科医院胸外科单一治疗组应用气动臂辅助实施单人单孔各类胸腔镜肺手术40例相关临床资料，包括手术时间、出血量、术后并发症和住院时间。其中肺叶／肺段切除术23例作为观察组，与同期开展的30例助手扶镜的单孔胸腔镜肺叶／肺段切除术（对照组）进行比较。结果观察组术后平均住院（4．6±1．3）天，术后引流管留置时间（46．7±18．6）h；观察组和对照组手术时间分别（121．74±25．16）min、（119．7±14．26）min，术中出血量（91．74±32．88）ml、（89．00±41．22）ml，无统计学差异（P〉0．05）。结论气动臂辅助单人单孔手术中镜头视野和调整更为精准稳定，手术时间、出血量与常规助手扶镜的单孔胸腔镜手术相似，能节省人力资源，操作安全，可完成多类胸外科手术操作，值得有条件的单位推广。

Objective To evaluate the application effect of pneumatic arm assisted single surgeon uniportal thoracoscopic surgery. Methods A total of 40 patients were admitted to our treatment group in Shanghai Pulmonary hospital in October who accepted pneumatic arm assisted single surgeon uniportal thoracoscopic surgery. All the clinic statistics of patients were collect- ed including operative time, the volume of blood intra-operation, postoperative complications and hospitalization time. 23 of 40 patients who accepted lobectomy/segmentectomy with pneumatic arm assisted single surgeon uniportal thoracoseopic surgery were assigned to the observation group, while another 30 concurrent patients who accepted lobectomy/segmentectomy with con- ventional uniportal thoracoscopic surgery were assigned to the control group. Both groups were compared. Results The average postoperative hospitalization time of observation group was（4.6 ± 1.3 ） days. The average time for postoperative drainage tube retention was（46.7 ± 18.6） hours. The average operation time of patients in observation and control groups was（ 121.74 ± 25.16） min and（ 119.7 ±14.26） min separately. The volume of blood intra-operation in observation group was（91.74 ±32. 88 ）ml and（ 89.00 ±41.22 ） ml in control group. There is no significant difference between two groups （P 〉 0.05 ）. Conclu- sion The field of view and adjustment of camera in uniportal thoracoscopic surgery by single surgeon with pneumatic arm assis- tance are more accurate and steady, in which human resource can be saved. It is safe and reliable and does not prolong opera- tive time or increase bleeding during operation, and can be applied to different kinds of diseases in thoracic surgery. It is worth promotion and application in eligible hospitals and medical institutions.