The efficacy of da Vinci robot-assisted lobectomy versus segmentectomy for stage ⅠA non-small cell lung cancer: A retrospective cohort study
- VernacularTitle:达芬奇机器人辅助肺叶和肺段切除术治疗ⅠA期非小细胞肺癌疗效的回顾性队列研究
- Author:
Yuchi WU
1
,
2
;
Shiguang XU
3
;
Wei XU
3
;
Hao MENG
3
;
Xilong WANG
3
;
Renquan DING
3
;
Shiqi WANG
3
;
Bo LIU
3
;
Dazhi LIU
3
;
Hong TENG
3
;
Shumin WANG
3
Author Information
1. 1.Postgraduate Training Base of General Hospital of the Northern Theater Command, China Medical University, Shenyang, 110016, P. R. China
2. 2. Department of Thoracic Surgery, General Hospital of the Northern Theater Command, Shenyang, 110016, P. R. China
3. Department of Thoracic Surgery, General Hospital of the Northern Theater Command, Shenyang, 110016, P. R. China
- Publication Type:Journal Article
- Keywords:
Da Vinci robot;
stage ⅠA non-small cell lung cancer;
segmentectomy;
lobectomy;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(01):58-64
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare and analyze the therapeutic effects of robot-assisted lobectomy and segmentectomy for stage ⅠA non-small cell lung cancer with a diameter≤2 cm. Methods A total of 181 patients with pathologically confirmed stage ⅠA non-small cell lung cancer (diameter≤2 cm) who underwent robot-assisted lobectomy and segmentectomy in our hospital from 2018 to 2021 were included. There were 74 males and 107 females with an average age of 57.50±10.60 years. They were divided into two groups according to the surgical procedure: a segmentectomy group (85 patients) and a lobectomy group (96 patients). Results There was no statistically significant difference between the two groups in terms of clinical data such as age, gender, smoking history, basic disease, pathological type, tumour diameter, operative time, postoperative 24 h drainage volume and overall complications (P>0.05). The intraoperative blood loss (33.88±16.26 mL vs. 39.27±19.48 mL, P=0.046), groups of dissected lymph nodes (4.76±1.19 vs. 5.52±1.46, P=0.000), number of dissected lymph nodes (14.81±7.23 vs. 18.06±7.70, P=0.004) and postoperative 72 h drainage volume (561.65±225.31 mL vs. 649.84±324.34 mL, P=0.037) of patients in the segmentectomy were less than those in the lobectomy group. The chest drainage time (5.49±3.92 d vs. 7.60±4.96 d, P=0.002) and postoperative hospital stay time (7.47±4.16 d vs. 9.67±5.50 d, P=0.003) were shorter than those in the lobectomy group. There was no conversion to thoracotomy or perioperative death in the two groups. The postoperative follow-up rate was 100.0% with a longest follow-up time of 48 months. The 3-year recurrence-free survival rates of the segmentectomy group and lobectomy group were 87.7% and 92.4%, respectively (P=0.465). Conclusion The da Vinci robot-assisted lobectomy and segmentectomy are safe and feasible surgical procedures for patients with stage ⅠA non-small cell lung cancer (diameter≤2 cm), with a similar 3-year recurrence-free survival rate. The lobectomy group has more lymph nodes dissected, while the segmentectomy group is superior to the lobectomy group in terms of intraoperative blood loss, postoperative 72 h chest drainage volume, chest drainage time and postoperative hospitalization time.
