达芬奇机器人辅助纵隔肿瘤切除术339例近期疗效分析:一项单中心回顾性病例对照研究

Curative effect analysis of Da Vinci™Robot-assisted surgery for 339 cases with mediastinal tumor:a single center retrospective case-control study

目的探讨达芬奇机器人纵隔肿瘤切除效果,总结达芬奇机器人手术系统在纵隔肿瘤手术中的应用经验。方法回顾性分析2015年4月至2020年9月期间上海市胸科医院开展的339例机器人纵隔肿瘤切除术患者临床资料。比较机器人手术与同期2949例常规电视胸腔镜手术患者的近期临床疗效。结果机器人手术组均按照术前设计成功完成手术,无病灶残留,无术中中转开胸,无术后非计划二次手术。机器人手术组手术时间(81.8±36.8)min,常规胸腔镜手术组(95.6±58.3)min,两组差异有统计学意义(P=0.015)。机器人手术组术中出血量(43.2±22.6)ml,常规胸腔镜手术组(44.0±33.4)ml,两组差异无统计学意义(P>0.05)。机器人手术组术后住院(3.1±1.9)天,常规胸腔镜手术组(3.8±2.3)天,两组差异有统计学意义(P=0.002)。结论应用达芬奇机器人系统行纵隔肿瘤切除术安全可行,相比于常规胸腔镜手术,缩短了手术时间,减少了术后住院时间,值得推广。

Objective To investigate the efficacy of Da Vinci robot-assisted surgery for mediastinal tumor,and summarize the value of Da Vinci system in mediastinal surgery.Methods The clinical data of 339 cases of robot-assisted mediastinal mass in Shanghai Chest Hospital from April 2015 to September 2020 were retrospectively analyzed,to compare perioperative outcomes of robotic surgery and conventional video-assisted thoracoscopic surgery 2949 cases.Results All the operations were successfully completed as planned.No residual lesions,conversion or second operation was observed in the consecutive cohort.The operating time[(81.8±36.8)min vs.(95.6±58.3)min,P=0.015]and post-operation stay[(3.1±1.9)days vs.(3.8±2.3)days,P=0.002]were statistically shorter in robotic group than those inconventional thoracoscopic group.Intraoperative blood loss in two groups was similar[(43.2±22.6)ml vs.(44.0±33.4)ml,P>0.05].Conclusion The Da Vinci robot system in mediastinal surgery is safe and feasible with great perspective in the new age of minimally invasive thoracic surgery.Compared with thoracoscopic surgery,it can shorten the operation time and reduce the postoperative hospital stay.It has certain advantages in operator experience and patient recovery.