达芬奇机器人与单孔、三孔胸腔镜肺癌根治术的临床疗效比较

Da Vinci robotic surgery,uniportal and three portal video-assisted thoracic surgery for radical lung cancer:A comparative study

目的:分析并比较达芬奇机器人与单孔、三孔胸腔镜肺癌根治术的临床疗效。方法:回顾性分析2018年1月至2019年8月我院行肺癌根治术的患者129例,其中,单孔胸腔镜组为42例,三孔胸腔镜组为56例,达芬奇机器人组为31例。比较三组的术中出血量、清扫淋巴结数量、手术时间以及术后疼痛情况、胸腔总引流量、住院时间、住院总费用等。结果:三种手术方式在手术时间、术中出血量及清扫淋巴结个数方面差异均无统计学意义(P>0.05),在术后疼痛、住院时间、住院总费用方面差异有统计学意义(P<0.05)。与三孔胸腔镜组相比,达芬奇机器人组的术中出血量较少[(72.14±36.72)ml,P=0.026]、清扫淋巴结个数较多(18.13±8.24,P=0.029)、住院时间较短[(5.31±2.98)d,P<0.001]。结论:达芬奇机器人手术相较于三孔胸腔镜手术优势明显,而相较于单孔胸腔镜手术优势不明显,但在复杂手术操作中是一种较好的手术选择方式。

Objective:To analyze and compare the clinical efficacy of Da Vinci robotic surgery,uniportal and three portal video-assisted thoracic surgery for radical lung cancer.Methods:From January 2018 to August 2019,129 patients underwent radical resection of lung cancer were selected.Among them,42 were in the single-hole group,56 in the three-hole group and 31 in the Da Vinci robot group.The intraoperative bleeding volume,number of lymph node dissection,operation time,postoperative pain,total thoracic drainage,length of stay,total hospitalization costs were compared among the three groups.Results:There were no significant differences in operation time,bleeding volume and number of lymph nodes dissected among the three groups(P>0.05),but there were significant differences in postoperative pain,hospitalization time and total cost of hospitalization(P<0.05).Compared with the three-hole group,the robot group had less intraoperative bleeding[(72.14±36.72)ml,P=0.026],more lymph nodes(18.13±8.24,P=0.029)and shorter hospital stay[(5.31±2.98)d,P<0.001].Conclusion:Da Vinci robotic surgery has obvious advantages over three-hole video-assisted thoracic surgery,but no obvious advantages over single-hole video-assisted thoracic surgery,and it is a better choice in complex operation.