论文部分内容阅读
目的评估应用机器人手术系统为高龄患者行肺叶切除术的可行性和安全性。方法沈阳军区总医院胸外科在2012年5月至2015年3月期间共为25例70岁以上患者施行机器人肺癌根治术治疗作为机器人组,男17例、女8例,年龄(72.6±2.5)岁,筛选同期行胸腔镜肺癌根治术治疗高龄肺癌患者25例作为胸腔镜组,男17例、女8例,年龄(72.5±2.4)岁。两组患者均行肺叶切除术同期行肺门、纵隔淋巴结清扫术,比较两组疗效差异。结果两组患者全部为肺恶性肿瘤。机器人组25例患者在机器人下完成手术,手术完成率100%;胸腔镜组25例,1例中转为开胸手术。两组患者术中失血量[(66.2±44.2)ml vs.(356.0±349.2)ml,P=0.000]、清扫淋巴结数量[(23.2±9.8)个vs.(11.3±5.6)个,P=0.012]及术后卧床时间[(3.5±0.9)d vs.(4.2±1.1)d,P=0.017]差异有统计学意义,机器人组优于胸腔镜组。结论达芬奇机器人手术系统对于高龄患者行肺癌根治术手术治疗安全、有效,且较胸腔镜手术创伤更小,患者恢复更快。
Objective To evaluate the feasibility and safety of using robotic surgery system for lobectomy in elderly patients. Methods From May 2012 to March 2015, a total of 25 patients under the age of 70 were treated with robotic lung cancer radical mastectomy as a robot group, including 17 males and 8 females, with a mean age of (72.6 ± 2.5) Thirty-seven men and 8 women (72.5 ± 2.4) years old underwent thoracoscopic radical resection of lung cancer undergoing thoracoscopic radical resection for advanced lung cancer. Two groups of patients underwent lobectomy concurrent hilar and mediastinal lymph node dissection, the difference between the two groups were compared. Results Both groups of patients were all lung malignancies. In the robot group, 25 patients underwent surgery under the robot. The rate of completion of surgery was 100%. In the thoracoscopic group, 25 patients were converted to thoracotomy. The mean amount of blood loss in the two groups was (66.2 ± 44.2) ml vs. (356.0 ± 349.2) ml, P = 0.000; the number of lymph nodes dissected was (23.2 ± 9.8) vs. (11.3 ± 5.6), P = 0.012 ] And postoperative bed rest time [(3.5 ± 0.9) d vs. (4.2 ± 1.1) d, P = 0.017]. The difference between the two groups was better than that of the thoracoscope group. Conclusion Da Vinci robotic surgical system is safe and effective in the elderly patients undergoing radical surgery for lung cancer. Compared with thoracoscope surgery, the da Vinci surgical system is less invasive and patients recover faster.