达芬奇机器人食管癌根治术后乳糜胸的分析

Analysis of chylothorax after esophagectomy by Da Vinci surgical system

目的目前比较达芬奇机器人与胸腔镜下食管癌根治术后乳糜胸的研究较少。文中旨在对达芬奇机器人食管癌根治术与胸腔镜术后乳糜胸进行分析。方法回顾性分析2014年1月至2020年6月东部战区总医院心胸外科收治的209例食管癌患者手术治疗的临床资料。根据纳入和排除标准最终纳入136例达芬奇机器人食管癌根治术患者(达芬奇机器人组)以及73例胸腔镜食管癌根治术患者(胸腔镜组)。统计分析2组食管癌根治术后乳糜胸发生率、术后24 h胸液量、胸管拔除时间等指标。结果达芬奇机器人组术后乳糜胸的发生率明显低于胸腔镜组(7.4%vs 16.4%,P=0.04),术后平均胸管拔除时间长于胸腔镜[(8.56±2.70)d vs(6.07±2.10)d,(P<0.01)]。术后第2、3、7天,达芬奇机器人组术后8 d内的每日胸腔引流量低于胸腔镜组(P<0.05)。结论达芬奇机器人在预防食管癌根治术后乳糜胸方面相较于胸腔镜更具优势,值得临床推荐。

Objective This article aimed to explore the incidence of postoperative chylothorax between Da Vinci surgical system and video-assisted thoracoscopy after esophagectomy,which was few in the literature.Methods The information of 209 patients who underwent esophagectomy in the Cardio-Thoracic Surgery Department of the General Hospital of Eastern Theater Command from January 2014 to June 2020 was retrospectivelyassessed.As per the inclusion and exclusioncriteria,the patients were divided into two groups,the Da Vinci group with 136 patients and the video-assisted thoracoscopy group with 73 patients.The incidence of postoperative chylothorax,the pleural fluid after 24 hours,the time of chest tube removal and etc.are statistically analyzed.Results The incidence of postoperative chylothoraxof the Da Vincigroup was lower than that of the video-assisted thoracoscopy group(7.4%vs 16.4%,P=0.04).The time of chest tube removal ofthe Da Vincigroup was more than thatof the video-assisted thoracoscopy group(8.56±2.70 days vs 6.07±2.10 days,P<0.001).Thepleural drainage of the Da Vincigroupwas lower than that of the video-assisted thoracoscopy groupin eight days after surgery.Conclusion Comparedto video-assisted thoracoscopy,Da Vinci surgical system is with lower incidence of postoperative chylothorax,which is recommended.