首页|达芬奇机器人与胸腔镜经剑突下入路治疗前纵隔肿瘤临床疗效的回顾性队列研究

达芬奇机器人与胸腔镜经剑突下入路治疗前纵隔肿瘤临床疗效的回顾性队列研究

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目的 比较达芬奇机器人与胸腔镜经剑突下入路治疗前纵隔肿瘤的安全性及有效性.方法 回顾性分析2020年6月—2022年4月兰州大学第一医院胸外科同一医疗组收治的经剑突下入路接受前纵隔肿瘤切除术患者的临床资料.按照手术方式,将患者分为达芬奇机器人辅助胸腔镜手术(robot-assisted thoracoscopic surgery,RATS)组和电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)组.比较两组患者围手术期资料及术后并发症发生率.结果 共纳入79例患者,其中RATS组41例,男13例、女28例,平均年龄(45.61±14.99)岁;VATS组38例,男14例、女24例,平均年龄(47.84±15.05)岁.全组患者均顺利完成手术.RATS组住院费用、手术时间高于或长于VATS组,差异有统计学意义(P<0.05);RATS组术中出血量,术后住院时间,术后进食水时间,术后下地活动时间,术后第1 d白细胞计数、中性粒细胞百分比及视觉模拟评分,术后第3d白细胞计数及中性粒细胞百分比,镇痛泵使用时间,自主按压镇痛泵次数,纵隔腔引流量均优于VATS组,差异有统计学意义(P<0.05);两组患者术后第3d视觉模拟评分、引流管留置时间、术后并发症发生率差异无统计学意义(P>0.05).结论 RATS经剑突下前纵隔肿瘤切除术是一种安全可行的手术方法,损伤更小、安全性更高,有利于患者术后快速康复,临床应用前景广泛.
Clinical efficacy of da Vinci robotic and thoracoscopic transxiphoid approach in the treatment of anterior mediastinal tumors:A retrospective cohort study
Objective To compare the safety and efficacy of the da Vinci robot and thoracoscopic subxiphoid approach for the treatment of anterior mediastinal tumors.Methods The clinical data of patients who underwent anterior mediastinal tumor resection through the subxiphoid approach admitted to the same medical group in the Department of Thoracic Surgery of the First Hospital of Lanzhou University between June 2020 and April 2022 were retrospectively analyzed.According to the surgery approach,the patients were divided into a robot-assisted thoracoscopic surgery(RATS)group and a video-assisted thoracoscopic surgery(VATS)group.The perioperative data and the incidence of postoperative complications were compared between the two groups.Results A total of 79 patients were enrolled.There were 41 patients in the RATS group,including 13 males and 28 females,with an average age of 45.61±14.99 years.There were 38 patients in the VATS group,including 14 males and 24 females,with an average age of 47.84±15.05 years.All patients completed the surgery successfully.Hospitalization cost and operative time were higher or longer in the RATS group than those in the VATS group,and the difference was statistically significant(P<0.05).Intraoperative bleeding,postoperative hospital stay,postoperative water and food intake time,postoperative off-bed activity time,white blood cell count,neutrophil percentage and visual analogue scale(VAS)score on the first postoperative day,white blood cell count and neutrophil percentage on the third postoperative day,duration of analgesic pump use,the number of voluntary compressions of the analgesic pump,and mediastinal drainage volume were all superior to those in the VATS group(P<0.05).The differences in VAS scores on the third postoperative day,duration of drainage tube retention and postoperative complication rates were not statistically different between the two groups(P>0.05).Conclusion RATS subxiphoid anterior mediastinum tumor resection is a safe and feasible surgical method with less injury and higher safety,which is conducive to rapid postoperative recovery and has wide clinical application prospects.

Robot-assisted thoracoscopic surgeryvideo-assisted thoracoscopic surgerysubxiphoid approachanterior mediastinal tumor

王晨晗、王锋、胡文滕、蔺瑞江、梁秋豪、袁博文、马敏杰、韩彪

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兰州大学第一临床医学院(兰州 730000)

兰州大学第一医院胸外科(兰州 730000)

机器人辅助胸腔镜手术 电视辅助胸腔镜手术 剑突下入路 前纵隔肿瘤

甘肃省自然科学基金甘肃省青年科技基金甘肃省青年科技基金

21JR1RA11821JR1RA10718JR3RA305

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(2)
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