摘要
目的比较机器人辅助下复杂肺段切除术与简单肺段切除术治疗ⅠA期非小细胞肺癌(non-small cell lung cancer,NSCLC)的围术期结果。方法回顾性分析上海交通大学附属胸科医院2015年1月—2021年8月采用机器人辅助下胸腔镜手术(robot-assisted thoracic surgery,RATS)完成解剖性肺段切除术治疗285例NSCLC患者的临床资料,其中男105例、女180例,年龄23~83岁。将285例患者按肿瘤位置及切除方式分为复杂肺段组(170例)和简单肺段组(115例);比较两组患者的临床病理基线特征以及围术期结果差异,包括手术时间、术中出血量、淋巴结清扫数量、中转开胸率、胸腔引流管留置时间、术后住院时间、持续性肺漏气发生率、术后30 d死亡等。结果两组患者的临床病理基线特征差异无统计学意义(P>0.05)。两组均无术后30 d死亡。RATS复杂肺段组有1例中转开胸。复杂肺段组与简单肺段组在手术时间[(97.36±38.16)min vs.(94.65±31.67)min,P=0.515]、胸腔引流管留置时间[(3.69±1.85)d vs.(3.60±1.90)d,P=0.679]、术后住院时间[(4.07±1.85)d vs.(4.05±1.97)d,P=0.957]、淋巴结清扫数量[(5.15±3.53)枚vs.(5.13±2.93)枚,P=0.952]、术中出血量<100 mL患者比例(98.2%vs.99.1%,P=0.650)、术后持续性肺漏气发生率(6.5%vs.5.2%,P=0.661)差异均无统计学意义。结论RATS复杂肺段切除术与简单肺段切除术治疗ⅠA期NSCLC安全有效,两种解剖性切除术的围术期结果基本相当。
Objective To compare the perioperative outcomes between robot-assisted complex segmentectomy and simple segmentectomy for stageⅠA non-small cell lung cancer(NSCLC).Methods The clinical data of 285 patients with NSCLC undergoing robot-assisted thoracic surgery(RATS)in our hospital from January 2015 to August 2021 were retrospectively analyzed.There were 105 males and 180 females aged 23-83 years.The patients were divided into a complex segmentectomy group(n=170)and a simple segmentectomy group(n=115)according to tumor location and surgical method.The clinical pathological baseline characteristics and perioperative outcomes between the two groups were compared,including operative time,blood loss volume,dissected lymph nodes,conversion rate,postoperative duration of drainage,postoperative hospital stay,the incidence of persistent air leakage and postoperative 30 d mortality.Results There was no statistical difference in baseline data between the two groups(P>0.05).No postoperative 30 d death was observed.One patient in the complex segmentectomy group was transferred to thoracotomy.No statistical difference was observed between the two groups in the operative time(97.36±38.16 min vs.94.65±31.67 min,P=0.515),postoperative duration of drainage(3.69±1.85 d vs.3.60±1.90 d,P=0.679),postoperative hospital stay(4.07±1.85 d vs.4.05±1.97 d,P=0.957),dissected lymph nodes(5.15±3.53 vs.5.13±2.93,P=0.952),incidence of blood loss volume<100 mL(98.2%vs.99.1%,P=0.650),and incidence of postoperative persistent air leakage(6.5%vs.5.2%,P=0.661).Conclusion The safety and effectiveness of robot-assisted complex segmentectomy and simple segmentectomy are satisfactory in the treatment of stageⅠA NSCLC.The perioperative results of RATS complex segmentectomy and simple segmentectomy are similar.
作者
侯煜铖
章剑锋
宋伟健
罗清泉
周谦君
HOU Yucheng;ZHANG Jianfeng;SONG Weijian;LUO Qingquan;ZHOU Qianjun(Department of Oncology Surgery,Shanghai Lung Tumor Clinical Medical Center,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai,200030,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2022年第9期1128-1132,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家自然科学基金面上项目(81772482)
上海市科委科技创新行动计划重大项目(20511105204)。
