临床荟萃

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达芬奇机器人和传统胸腔镜手术治疗肺部疾病的疗效

  

  1. 1.甘肃中医药大学 临床医学院,甘肃 兰州 730000;2.甘肃省人民医院 胸外科,甘肃 兰州 730000
  • 出版日期:2019-11-20 发布日期:2020-01-09
  • 通讯作者: 苟云久,Email:gouyunjiu@163.com
  • 基金资助:
    甘肃省卫生行业科研计划项目----高海拔地区非小细胞肺癌患者接受达芬奇机器人肺叶切除的临床疗效(GSWSKY2017-56);甘肃省人民医院院内科研基金----达芬奇机器人肺叶切除在高海拔地区肺癌患者中的临床疗效(16GSSY3-1)

Efficacy of Da Vinci robot and traditional videoassisted thoracic surgeryin  the treatment of pulmonary diseases

  1. 1.Clinical Medical Institute affiliated to Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China; 
    2.Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
  • Online:2019-11-20 Published:2020-01-09
  • Contact: Corresponding author: Gou Yunjiu, Email: gouyunjiu@163.com

摘要: 目的  评价达芬奇机器人手术(robotassisted thoracic surgery, RATS)和胸腔镜手术(videoassisted thoracic surgery, VATS)治疗肺部疾病的疗效。方法  对收治的218例行达芬奇机器人和传统胸腔镜手术诊治肺部疾病的临床资料进行回顾性分析。患者自愿选择手术方式,其中RATS组98例,VATS组120例。结果   RATS组手术时间较VATS组长(P<0.01),手术费用(P<0.05)和住院总花费(P<0.01)较VATS组多。RATS组术中失血量更少(P<0.01),术后住院时间更短(P<0.05)。两组在中转开胸手术、总引流量、术后引流时间差异均无统计学意义(P>0.05)。肺癌患者中RATS组术后住院时间更短(P<0.01),住院总花费更高(P<0.01)。非肺癌患者RATS组手术时间更长(P<0.01),住院总花费更高(P<0.01);RATS组术中失血量更少(P<0.05),术后住院时间更短(P<0.05)。结论  达芬奇机器人辅助胸腔镜手术是安全有效的,其在术中出血量和术后住院时间具有明显的优势,而其他指标在机器人手术中无明显优势。

关键词: 机器人, 肺外科手术, 胸腔镜, 肺疾病

Abstract: Objective  To evaluate the efficacy of Da Vinci robotassisted thoracic surgery (RATS) and videoassisted thoracic surgery (VATS) in the treatment of pulmonary diseases.Methods  The clinical data of 218 patients with pulmonary diseases and treated with Da Vinci RATS and and traditional VATS were retrospectively analyzed. Patients chose the surgical method on their own, including 98 cases in RATS group and 120 cases in VATS group.Results  The operation time of RATS group was longer than that of VATS group (P<0.01), and the surgical cost  (P<0.05) and total hospitalization costs (P<0.01)   of RATS were also higher than those of VATS group.  However  RATS group had less intraoperative blood loss (P<0.01)  and shorter postoperative hospital stay (P<0.05).There were no statistically significant differences between two groups in the conversion to thoracotomy, total drainage volume and  postoperative drainage time (P>0.05). Patients with lung cancer in RATS group had shorter postoperative hospital stay (P<0.01) and higher total hospital costs(P<0.01). Nonlung cancer patients in  RATS group had longer surgery time (P<0.01) and higher overall hospital costs (P<0.01). Patients in RATS group had less intraoperative blood loss(P<0.05)  and shorter postoperative hospital stay (P<0.05).Conclusion  Da  Vinci RATS  is safe and effective,and it has obvious advantages in intraoperative blood loss and postoperative hospital stay, while other indicators have no obvious advantages in   robot assisted surgery.

Key words: robotics;pulmonary , surgical , procedures, thoracoscopes, lung diseases