Robotic lung resection for malignant and benign lesions: experience with 1 000 patients
10.7507/1007-4848.201809048
- VernacularTitle:连续 1 000 例机器人辅助胸腔镜肺部手术回顾性分析
- Author:
LI Chongwu
1
;
HUANG Jia
1
;
LI Jiantao
1
;
LI Hanyue
1
;
LIN Hao
1
;
LU Peiji
1
;
LUO Qingquan
1
Author Information
1. Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, P.R.China
- Publication Type:Journal Article
- Keywords:
da Vinci robotic thoracic surgery;
perioperative outcome;
non-small cell lung cancer;
hospital cost
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(1):42-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the perioperative outcome of consecutive 1 000 patients undergoing robotic lung resection and summarize surgical experience. Methods We retrospectively reviewed the clinical data of 1 000 patients undergoing robotic lung resection between May 2009 and June 2018 in Shanghai Lung Tumor Clinical Medical Center. Robotic lobectomy was compared with traditional VATS over the same period using a propensity-matched analysis. There were 327 males and 673 females at average age of 56.21±11.33 years. Lobectomy was performed in 866 patients (11 bilobectomy included), sublobar resection was performed in 129 patients, sleeve lobectomy was performed in the remaining 5 patients. Pathology was as follows: adenocarcinoma in 875 patients, squamous carcinoma in 52 patients, benign tumors in 73 patients. 90.5% of the primary lung cancer were in stage Ⅰ. Results The mean operative time was 90.31±19.70 min; 95.70% of patients’ estimated blood loss was less than 100 ml. Conversion rate to thoracotomy was 0.90% (9 patients) . The average lymph node station and count harvested was 5.59±1.36 and 9.60±3.21 respectively. The mean volume of chest tube drainage on the first postoperative day was 229.19±131.67 ml. Median chest tube time was 3.85±1.43 d. There was 1 in-hospital death due to pulmonary embolism. A total of 189 patients had postoperative complications (18.90%) whose majority was postoperative air leak more than 5 days. The mean overall hospital costs was 92 710.53±12 367.23 Yuan. Compared with VATS, RATS was associated with significant reduction in intraoperative blood loss, time to chest tube removal and postoperative hospital stay. The operative time, conversion rate, lymph nodes removed, morbidity and mortality were similar between the two groups. Conclusion Robotic-assisted lung resection is safe and effective with low conversion rate and less complications, and it can overcome many disadvantages of traditional VATS.
