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目的探索应用da Vinci机器人外科手术系统进行纵隔肿瘤切除术的安全性和有效性。方法分析我院从2009年5月至2015年3月由同一组医师施行的da Vinci机器人辅助纵隔肿瘤切除术47例患者的临床资料,其中男29例,女18例,中位年龄48(20~78)岁。所有手术通过1个12 mm观察孔,2个8 mm操作孔完成,不增加辅助切口。结果 47例行机器人纵隔肿瘤切除术的手术时间为(73±36)min,出血量为(48±15)ml,出现1例中转开胸(术中出血),死亡率为0,无术后并发症,无围术期输血。行机器人纵隔肿瘤切除术的手术时间随着手术例数的增加而明显缩短,20例后,手术时间基本稳定,存在明显的学习曲线,方程为:y(min)=-20.41 ln(x)+119.43,R2=0.312,P<0.01。结论机器人辅助纵隔肿瘤切除术安全有效,在微创胸外科有着广阔的应用前景。
Objective To explore the safety and effectiveness of da Vinci robotic surgical system for mediastinal tumor resection. Methods The clinical data of 47 patients with da Vinci robot-assisted mediastinum tumor resection from May 2009 to March 2015 in our hospital were analyzed, including 29 males and 18 females, with a median age of 48 (20 ~ 78) years old. All operations through a 12 mm observation hole, two 8 mm operation hole to complete, do not increase the auxiliary incision. Results The operation time was 73 ± 36 minutes, and the amount of bleeding was (48 ± 15) ml in 47 cases of robotic mediastinal tumor resection. There was 1 case of transcatheter thoracotomy (intraoperative bleeding) with a mortality of 0 and no postoperative Complications, no perioperative blood transfusion. The operation time of robot robotic mediastinal tumor resection was significantly shortened with the increase of operative cases. After 20 cases, the operation time was basically stable and there was a clear learning curve. The equation was: y min = - 20.41 ln x + 119.43, R2 = 0.312, P <0.01. Conclusions Robot-assisted mediastinum tumor resection is safe and effective, and it has broad application prospects in minimally invasive thoracic surgery.