达芬奇机器人系统在高龄患者肺癌根治术中的应用

da Vinci robot system for radical surgery of lung cancer in elderly patients

目的对比达芬奇机器人与电视胸腔镜肺癌根治术在高龄患者中的围手术期临床疗效。方法回顾性分析我院2016~2019年59例行肺癌根治术高龄患者(年龄>70岁)的临床资料。患者根据意愿选择手术方式,32例患者行达芬奇机器人肺癌根治术(达芬奇机器人组),其中男20例、女12例,平均年龄(73.1±2.3)岁;27例患者行单操作孔胸腔镜肺癌根治术(电视胸腔镜组),其中男16例、女11例,平均年龄(71.2±1.3)岁。比较两组患者的临床资料。结果达芬奇机器人组和电视胸腔镜组手术时间差异无统计学意义(t=–0.341,P=0.484)。与电视胸腔镜组相比,达芬奇机器人组清扫淋巴结数量更多(t=1.635,P=0.015)、术中出血量更少(t=–2.569,P<0.001)、术后3 d胸腔引流量更少(t=–6.325,P=0.045)以及术后第3 d疼痛视觉模拟评分更低(t=–7.214,P=0.021)。结论老年肺癌患者行达芬奇机器人根治术是安全、有效的,且创伤更小。

Objective To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer.Methods We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019.These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery(VATS)group according to the patients’selection of the treatments.There were 32 patients with 20 males and 12 females aged73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group.The clinical data of the two groups were compared.Results There was no statistical difference in surgery time between the two groups(t=–0.341,P=0.484).Compared with the VATS group,the da Vinci robot group had more number of lymph nodes dissected(t=1.635,P=0.015),less intraoperative blood loss(t=–2.569,P<0.001),less postoperative drainage amount within 3 days after surgery(t=–6.325,P=0.045),lower visual analogue scale(VAS)scores at postoperative 3 rd day(t=–7.214,P=0.021).Conclusion The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.