|本期目录/Table of Contents|

[1]沈智敏,陈泓波,张培培,等.机器人辅助肺叶切除术的学习曲线[J].福建医科大学学报,2020,54(02):117-120.
 SHEN Zhimin,CHEN Hongbo,ZHANG Peipei,et al.Learning Curve of Robot-Assisted Lobectomy[J].Journal of Fujian Medical University,2020,54(02):117-120.
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《福建医科大学学报》[ISSN:1672-4194/CN:35-1192/R]

卷:
第54卷
期数:
2020年02期
页码:
117-120
栏目:
临床研究
出版日期:
2020-04-30

文章信息/Info

Title:
Learning Curve of Robot-Assisted Lobectomy
文章编号:
1672-4194(2020)02-0117-04
作者:
沈智敏1 陈泓波1 张培培1 陈 遂1 高 磊1 康明强123
1.福建医科大学 附属协和医院胸外科,福州 350001; 2.福建省消化道恶性肿瘤教育部重点实验室,福州 350122; 3.福建省肿瘤微生物重点实验室,福州 350122
Author(s):
SHEN Zhimin1 CHEN Hongbo1 ZHANG Peipei1 CHEN Sui1 GAO Lei1KANG Mingqiang123
1.Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China; 2.Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350122, China; 3.Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou 350122, China
关键词:
胸腔镜 机器人 肺切除术
Keywords:
thoracoscopes robotics pneumonectomy
分类号:
R-05; R443.8; R655; R655.3
DOI:
-
文献标志码:
A
摘要:
目的 探讨机器人辅助胸腔镜(RATS)下肺叶切除术在早期肺癌中的学习曲线。 方法 选择早期肺癌患者36例,均接受机器人辅助胸腔镜下肺叶切除治疗,回顾分析患者的资料。接受肺叶切除的患者按手术时间分为A,B,C组,每组12例,比较各组的平均手术时间、术中出血量、淋巴结清扫数目、胸腔引流量、胸导管拔管时间、术后住院时间及术后并发症等。 结果 肺叶切除A,B,C组患者的术中出血量分别为(109.6±65.2),(34.2±19.9)及(34.2±27.8)mL,A组分别与B组和C组比较,差别均有统计学意义(P<0.05); 3组患者的手术时间分别为(239.3±37.5),(193.5±29.8)及(171.3±40.0)min,胸腔引流管引流量分别为(1 049.0±476.0),(997.3±352.2)及(768.0±284.3)mL,淋巴结清扫数量分别为(14.7±3.4),(16.3±2.8)及(19.8±2.5)个,3组间3个指标差别均有统计学意义(P<0.05)。3组患者的术后并发症发生率、术后拔除胸腔引流管时间、术后住院时间等差别均无统计学意义(P>0.05)。 结论 在熟练掌握三孔电视胸腔镜(VATS)早期肺癌的肺叶切除术的基础上,采取RATS的学习曲线约需12例,术中出血量减少、手术时间缩短、胸腔引流量和淋巴结清扫数量可作为主要的衡量指标。
Abstract:
Objective To investigate the learning curve of robotic assisted(RATS)thoracoscopic lobectomy in early stage lung cancer. Methods 36 patients with early stage lung cancer, who underwent robot-assisted thoracoscopic lobectomy were selected, and the data of patients were retrospectively analyzed. The patients were divided into groups A, B, and C according to the operation time. Each group had 12 cases. The average operation time, intraoperative blood loss, lymph node dissection, chest drainage, thoracic duct extubation time, postoperative hospital stay and postoperative complications, etc. were compared. Results The intraoperative blood loss of group A, B, and C in the lobectomy group was(109.6±65.2),(34.2±19.9), and(34.2±27.8)mL. The difference between A group with B and C group was statistically significant(P<0.05). The operation time of patients in group A, B, and C was(239.3±37.5),(193.5±29.8), and(171.3±40.0)min, and the difference was statistically significant(P<0.05). The drainage of chest tube in patients in group A, B, and C were(1 049.0±476.0),(997.3±352.2), and(768.0±284.3)mL, respectively. The number of lymph node dissection in group A, B, and C was(14.7±3.4),(16.3±2.8), and(19.8±2.5), and the difference between the three groups was statistically significant(P<0.05). There were no significant differences in complications, postoperative drainage of the thoracic drainage tube, and postoperative hospital stay(P>0.05). Conclusions Based on the lobectomy of three-well VATS for early lung cancer, the RATS learning curve is about 12 cases. Reduced intraoperative blood loss, reduced operative time, chest drainage, and number of lymph nodes can be used as primary measure.

参考文献/References:

[1] Mu J W, Chen G Y, Sun K L, et al. Application of video-assisted thoracic surgery in the standard operation for thoracic tumors[J]. Cancer Biol Med, 2013, 10(1):28-35.
[2] Melfi F M, Menconi G F, Mariani A M, et al. Early experience with robotic technology for thoracoscopic surgery[J]. Eur J Cardio-Thorac, 2002, 21(5):864-868.
[3] Huang J, Luo Q, Tan Q, et al. Initial experience of robot-assisted thoracoscopic surgery in China[J]. Int J Med Robot,, 2014, 10(4):404-409.
[4] Adams R D, Bolton W D, Stephenson J E, et al. Initial multicenter community robotic lobectomy experience: comparisons to a national database[J]. Ann Thorac Surg, 2014, 97(6):1893-1900.
[5] Cerfolio R J, Ghanim A F, Dylewski M, et al. The long term survival of robotic lobectomy for non-small cell lung cancer: a multi-institutional study[J]. J Thorac Cardiovasc Surg,2018, 155(2): 778-786.
[6] Yang H X, Woo K M, Sima C S, et al. Long-term survival based on the surgical approach to lobectomy for clinical stageⅠnonsmall cell lung cancer: comparison of robotic, video-assisted thoracic surgery, and thoracotomy lobectomy[J]. Ann Surg, 2017,265(2):431-437.
[7] Roy L, Susana M M, Emad M, et al. Single-port versus multi-port robotic sacrocervicopexy: Establishment of a learning curve and short-term outcomes[J]. Eur J Obstet Gynecol Reprod Biol, 2019,239:1-6.
[8] Kim, Kown H G, Lin H,et al. Quantitative assessment of the learning curve for robotic thyroid surgery[J]. J Clin Med, 2019,8(3):402.
[9] Kassite I, Bejan-Angoulvant T, Lardy H, et al. A systematic review of the learning curve in robotic surgery: range and heterogeneity[J]. Surg Endosc, 2019,33(2):353-365.
[10] Meyer M, Gharagozloo F, Tempesta B, et al. The learning curve of robotic lobectomy[J].Int J Med Robot, 2012,8(4):448-452.
[11] Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer[J]. J Thorac Cardiovasc Surg, 2010,140(1):19-25.
[12] Baldonado J J A R, Amaral M, Garrett J, et al. Credentialing for robotic lobectomy: what is the learning curve? A retrospective analysis of 272 consecutive cases by a single surgeon[J]. J Robot Surg, 2019,13(5):663-669.
[13] Ma M F, Olivia F, Federico D, et al. Robotic lobectomy for lung cancer: evolution in technique and technology[J]. Eur J Cardiothorac Surg, 2014, 46(4):626-630.
[14] Pierluigi N, Edoardo B, Emanuele V, et al. Robotic surgery, video-assisted thoracic surgery, and open surgery for early stage lung cancer: comparison of costs and outcomes at a single institute[J]. J Thorac Dis, 2018,10(2):790-798.
[15] Giulia V. Robotic surgery for the treatment of early-stage lung cancer[J]. Curr Opin Onco, 2013,25(2):107-114.
[16] Ahn S, Jeong J Y, Kim H W, et al. Robotic lobectomy for lung cancer: initial experience of a single institution in Korea[J].Ann Cardiothorac Surg, 2019,8(2):226-232.
[17] Chen S, Huang S J, Yu S B, et al. The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection[J]. J Thorac Dis, 2019,11(2):477-487.

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备注/Memo

备注/Memo:
收稿日期: 2019-07-08基金项目: 国家自然科学基金(81773129); 福建省科技创新联合项目(2017Y9039); 福建医科大学启航基金(2017Y2027)作者简介: 沈智敏,男,住院医师,福建医科大学2018级博士研究生通讯作者: 康明强. Email:mingqiang_kang@126.com
更新日期/Last Update: 2020-04-30