多学科诊疗联合达芬奇机器人手术治疗早期非小细胞肺癌临床疗效的单中心回顾性研究

Efficacy of multidisciplinary team combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer:A retrospective study in a single center

目的探讨多学科诊疗(multidisciplinary team,MDT)模式联合达芬奇机器人手术治疗早期非小细胞肺癌的临床疗效。方法回顾性纳入北部战区总医院胸外科2020年7月—2021年12月收治的经达芬奇机器人手术治疗非小细胞肺癌患者。根据是否采用MDT模式,将患者分为MDT组和普通组,比较两组临床疗效。结果共纳入187例患者,其中男81例、女106例,年龄63(56,67)岁。MDT组85例,普通组102例。在同种手术模式下,与普通组相比,MDT组术后并发症发生率更低(9.4%vs.29.4%,P=0.017),手术时间更短[55(45,61)min vs.79(65,90)min,P<0.001],术中出血量更少[25(20,30)mL vs.30(20,50)mL,P=0.029]。另外,MDT组患者术后第2 d胸腔引流量[270(200,350)mL vs.215(190,300)mL,P=0.004]、术中清扫淋巴结组数[6(5,6)组vs.5(3,6)组,P=0.004]与枚数[16(13,21)枚vs.13(9,20)枚,P=0.005]显著优于普通组。两组患者在术后带管时间、术后住院时间等方面差异无统计学意义(P>0.05)。结论MDT模式联合达芬奇机器人可进一步降低手术风险,改善患者的临床治疗效果,降低术后并发症发生率,加快患者康复。

Objective To investigate the clinical efficacy of multidisciplinary team(MDT)model combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer(NSCLC).Methods From July 2020 to December 2021,the patients with NSCLC who received Da Vinci robot-assisted thoracic surgery in the Department of Thoracic Surgery,General Hospital of Northern Theater Command were collected.According to whether MDT were performed before hospitalization,the patients were divided into an MDT group and a common group.The recovery and clinical efficacy were compared between the two groups.Results A total of 187 patients were enrolled,including 81 males and 106 females,aged 63(56,67)years.There were 85 patients in the MDT group,and 102 patients in the common group.Compared with the common group,the MDT group had lower incidence of postoperative complications(9.4%vs.29.4%,P=0.017),shorter intraoperative operation time[55(45,61)min vs.79(65,90)min,P<0.001],and less intraoperative blood loss[25(20,30)mL vs.30(20,50)mL,P=0.029]in the same operation mode.In addition,the drainage volume on the second postoperative day[270(200,350)mL vs.215(190,300)mL,P=0.004],the number of dissected lymph nodes groups[6(5,6)groups vs.5(3,6)groups,P=0.004]and the number of dissected lymph nodes[16(13,21)vs.13(9,20),P=0.005]in the MDT group were significantly better than those in the common group.The differences in the postoperative intubation time and postoperative hospital stay between the two groups were not statistically significant(P>0.05).Conclusion MDT combined with Da Vinci robot-assisted thoracic surgery can further reduce the risk of surgery,improve the clinical treatment effect,reduce the incidence of postoperative complications,and accelerate the rehabilitation of patients.