【摘要】 目的研究比较机器人肺叶切除术和胸腔镜肺叶切除术在早期非小细胞肺癌的手术效果及安全性。方法纳入南昌大学第一附属医院胸心外科同一手术小组2016年1月至2018年1月患者,符合入组标准的113例早期非小细胞肺癌患者按手术方式非随机分组为机器人辅助胸腔镜手术(57例)和常规胸腔镜手术(56例)。术前患者采用年龄(±5岁)和相关基础病史配对方案。前瞻性对比观察两组患者的淋巴结升期率、手术时间、术前准备时间、术中出血量、引流时间、术后第2天疼痛评分、术后住院时间及围手术期并发症。结果两组患者淋巴结升期率比较、手术时间、术后第2天疼痛评分、淋巴结清除数比较差异均无统计学意义;机器人组术中出血量、引流时间及术后住院时间均低于胸腔镜组(均P <0.05);机器人组并发症发生率明显低于胸腔镜组(10.5%vs. 26.7%,P <0.05)。机器人组术前准备时间高于胸腔镜组(P <0.05)。结论机器人肺叶切除术比胸腔镜肺叶切除术在早期非小细胞肺癌患者中应用效果更好,更加安全,可在临床推广应用。更多还原

【Abstract】 Objective To compare the efficacy and safety of robotic lobectomy and thoracoscopic lobectomy in early stage non-small cell lung cancer. Methods From January 2016 to January 2018, 113 patients with early-stage non-small-cell lung cancer who met the inclusion criteria were included in the same surgical group of thoracic and cardiac surgery department of the first affiliated hospital of nanchang university. According to the surgical method, they were randomly divided into robot-assisted thoracoscopic surgery(57 cases) and conventional thoracoscopic surgery(56 cases). Preoperative age( ± 5 years) and relevant basic medical history were used to match the patients. The lymph node ascending rate, operative time, preoperative preparation time, intraoperative blood loss, drainage time, postoperative pain score on the second day, postoperative hospitalization time and perioperative complications of the two groups were compared prospectively. Results There was no significant difference in lymph node ascending rate, operation time, pain score on the second day after surgery and lymph node clearance number between the two groups. Intraoperative blood loss, drainage time and postoperative hospitalization time were lower than that of the thoracoscopy group(P < 0.05). The complication rate of the robot group was significantly lower than that in the thoracoscopy group( 10.5% vs. 26.7%,P < 0.05). The preoperative preparation time of the robot group was higher than that of the thoracoscopic group(P < 0.05). Conclusion Robot lobectomy is better and safer in patients with early non-small cell lung cancer than thoracoscopic lobectomy, and can be used in clinical application.更多还原