单操作孔机器人辅助肺切除术的可行性及安全性分析

Clinical analysis of the feasibility and safety of single utility port robot-assisted lung resection

目的探讨经前侧入路单操作孔达芬奇机器人辅助肺切除术的可行性及安全性。方法回顾性分析2021年2—3月于陆军军医大学大坪医院采用前侧入路单操作孔机器人肺切除的21例患者的临床资料,其中男10例、女11例,中位年龄50(34~66)岁。对手术时间、出血量、术后住院时间和并发症等指标进行分析总结。结果全组病例均顺利完成手术,无中转开胸,无围手术期死亡。中位手术时间103(70~200)min,其中中位Docking时间5(3~10)min,中位机器人手术操作时间81(65~190)min。中位出血量45(20~300)mL。所有病例均为恶性肿瘤,淋巴结清扫/采样站数3(1~6)站,淋巴结清扫/采样个数5(2~16)个,术后中位胸腔闭式引流管留置时间为3(2~5)d,术后中位住院时间5(3~7)d。术后前3 d疼痛评分(3±1)分。结论经前侧入路单操作孔机器人肺切除术创伤更小,且安全、便捷和有效,可在临床试用并逐步推广应用。

Objective To investigate the feasibility and safety of single utility port Da Vinci robot-assisted lung resection via anterior approach.Methods The clinical data of 21 patients who underwent single utility port Da Vinci robot-assisted lung resection from February to March 2021 were retrospectively analyzed.There were 10 males and 11 females,with a median age of 50(34-66)years.The operation time,blood loss,postoperative hospitalization time,postoperative complications and other indicators were analyzed.Results All patients completed the operation successfully with no transition to thoracotomy or perioperative death.Overall surgery time was 103(70-200)min,Docking time was 5(3-10)min,operation time was 81(65-190)min.The blood loss was 45(20-300)mL.All patients had malignant tumors,the number of dissected lymph node station was 3(1-6),and the number of lymph nodes was 5(2-16).The postoperative indwelling time was 3(2-5)d.The postoperative hospitalization time was 5(3-7)d.The pain score for the first 3 days after surgery was 3±1 points.Conclusion Single utility port robot-assisted lung resection via anterior approach is safe,less traumatic,more convenient and effective,which can be gradually promoted and applied to clinical trials.