胸腔镜与机器人肺段切除术后肺功能保留的比较研究

Comparative study of pulmonary function retention after video-assisted thoracic surgery and robot-assisted thoracic surgery

目的探讨胸腔镜辅助手术(video-assisted thoracic surgery,VATS)与机器人辅助手术(robotassisted thoracic surgery,RATS)肺段切除术后肺功能的变化。方法纳入2017年7~10月于青岛大学附属医院行肺段切除术患者59例,男30例、女29例,其中VATS组33例,男18例、女15例;RATS组26例,男12例、女14例。分别在术前、术后1个月、术后6个月及术后12个月进行肺功能检查。对两组患者肺功能保留值进行组内和组间比较,分析VATS及RATS肺段切除术后肺功能保留方面的差异。结果VATS组与RATS组的一秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)均在术后1个月较术前显著下降(P值均<0.05),而在术后6个月内明显上升(P值均<0.05),6个月后恢复不明显,且低于术前(P值均>0.05)。此外,组间比较发现VATS组与RATS组在术后1个月、6个月及12个月的FEV1、FVC保留相似,差异无统计学意义(P值均<0.05)。结论微创肺段切除术后1个月肺功能下降显著,术后6个月内恢复明显,此后逐渐平稳,术后12个月两组患者FEV1分别恢复至术前的93%与94%。VATS与RATS肺段切除术后肺功能保留方面无明显差异。

Objective To investigate the changes in pulmonary function after video-assisted thoracic surgery(VATS)and robot-assisted thoracic surgery(RATS)segmentectomy.Methods A total of 59 patients(30 males and 29 females)who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included.There were 33 patients(18 males and 15 females)in the VATS group and 26 patients(12 males and 14 females)in the RATS group.Lung function tests were performed before surgery,1 month,6 months,and 12 months after surgery.Intra-and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy.Results The forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)in the VATS group and the RATS group were significantly lower than those before surgery(P<0.05),and they increased significantly within 6 months after surgery(P<0.05).The recovery was not obvious after 6 months(P>0.05),and they were still lower than those before surgery.In addition,the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month,6 months,and 12 months after operation with no statistical difference(P>0.05).Conclusion Pulmonary function decreases significantly in 1 month after minimally invasive segmentectomy,and the recovery is obvious in 6 months after the operation,then the pulmonary function recovery gradually stabilizes 12 months after surgery.FEV1 of the patients in the two groups recovers to 93%and 94%,respectively.There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.