经前侧入路达芬奇机器人辅助肺段切除术的临床分析

Experience of robot-assisted lung segmentectomy through anterior approach

目的总结经前侧入路达芬奇机器人辅助肺段切除术治疗肺部结节的临床价值。方法回顾性分析2018年6月至2019年10月于我科行前侧入路达芬奇机器人辅助肺段切除术77例患者的临床资料,其中男22例、女55例,年龄53(30~71)岁。对患者症状、一般情况、术前影像学资料、切除肺段分布、手术时间、出血量、淋巴结清扫数、术后带管时间、引流量、术后住院时间、术后并发症以及围术期死亡等指标进行分析。结果所有患者均顺利完成手术,无中转开胸,无严重并发症,无围术期死亡。术后病理48例为早期肺癌,29例为良性肿瘤。机器人Docking时间4(1~30)min,机器人腔内操作时间76(30~170)min,出血量30(20~400)mL,术后胸腔闭式引流管引流时间4(2~15)d,术后总引流量780(200~3980)mL;术后住院时间7(3~19)d。结论经前侧入路机器人辅助肺段切除治疗肺部结节安全、便捷和有效,值得临床推广应用。

Objective To evaluate the feasibility and clinical value of robot-assisted lung segmentectomy through anterior approach.Methods We retrospectively analyzed the clinical data of 77 patients who underwent robotic lung segmentectomy through anterior approach in our hospital between June 2018 to October 2019.There were 22 males and 55 females,aged 53(30-71)years.Patients'symptoms,general conditions,preoperative imaging data,distribution of resected lung segments,operation time,bleeding volume,number of lymph node dissected,postoperative duration of chest tube insertion,drainage volume,postoperative hospital stay,postoperative complications,perioperative death and other indicators were analyzed.Results All operations were successfully completed.There was no conversion to thoracotomy,serious complications or perioperative death.The postoperative pathology revealed early lung cancer in 48 patients,and benign tumors in 29 patients.The mean clinical parameters were following:the robot Docking time 1-30(M=4)min,the operation time 30-170(M=76)min,the blood loss 20-400(M=30)mL,the drainage tube time 2-15(M=4)days,the drainage fluid volume 200-3980(M=780)mL and the postoperative hospital time 3-19(M=7)days.Conclusion Robotic lung segmentectomy through anterior approach is a safe and convenient operation method for pulmonary nodules.