Objective To summarize our initial experience in robot-assisted lobectomy for the treatment of non-small cell lung cancer (NSCLC). Methods A total of 20 NSCLC patients underwent robot-assisted pulmonary lobectomy in General Hospital of Shenyang Military Command from March to September 2012. There were 13 males and 7 females, and their age was 43-80 (60.40±8.07) years. Single-direction thoracoscopic lobectomy technique was used,and systemic mediastinal and hilar lymph node dissection was routinely performed during the operation. There were 4 right upper lobectomies,7 right lower lobectomies,1 right middle lobectomy,7 left lower lobectomies,and 1 left upper lobectomy. Results Postoperative pathological examination showed adenocarcinoma in 12 patients,squamous cell carcinoma in 5 patients,adenosquamous carcinoma in 2 patients,and mucoepidermoid carcinoma in 1 patient. One patient undergoing left upper lobectomy had intraoperative pulmonary artery bleeding of 500 ml,who was healed by pulmonary artery repair via an accessory small incision and blood transfusion of 400 ml. All the other 19 patients successfully underwent robot-assisted lobectomy with their mean intraoperative blood loss of 60.00±42.95 (10-200) ml, and no blood transfusion was needed for them. All the patients were successfully extubated after operation, and none of the patients had severe postoperative complication. The mean thoracic drainage time was 9.35±3.48 (3-15) days. All the patients were discharged uneventfully and followed up for 2-9 (6.01±2.09) months without recurrence or metastasis. Conclusions Robot-assisted pulmonary lobectomy using Da Vinci S Surgical System is safe and feasible,and especially advantageous for lymph node dissection. It can be used for the treatment of early stage NSCLC.
Citation:
WANG Shumin,XU Shiguang,TONG Xiangdong,LIU Bo,LI Bo,XU Wei,QU Jiaqi.. Robot-assisted Lobectomy for Non-Small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(3): 308-311. doi: 10.7507/1007-4848.20130093
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刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24 (3):156-158.
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罗宜人, 王耀鹏, 王明钊, 等. 临床I期非小细胞肺癌电视胸腔镜肺叶切除术中淋巴结清扫的对照研究. 中国微创外科杂志, 2011, 11 (1):73-75.
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陈胜, 胡卫建, 谷电雷. 全胸腔镜肺叶切除治疗早期肺癌22例临床报道. 临床肺科杂志, 2012, 17 (3):499-500.
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李凤卫, 姜冠潮, 李运, 等. 全胸腔镜与开胸肺叶切除治疗cNO-pN2非小细胞肺癌效果初步比较. 北京大学学报:医学版, 2011, 43 (6):861-865.
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李泽树, 杜波, 杨建国. 全胸腔镜下手术治疗26例早期肺癌的体会. 实用癌症杂志, 2010, 25 (6):607-608, 615.
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王如文, 邓波, 谭群友. 电视胸腔镜手术在肺癌治疗中有待解决的问题. 中华肺部疾病杂志:电子版, 2011, 04 (3):174-177.
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郭刚, 侯文俊, 李高峰, 等. 完全胸腔镜下肺叶切除术治疗非小细胞肺癌54例临床分析. 昆明医学院学报, 2011, 32 (9):24-27.
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胡定中, 林凌, 沈宇舟, 等. 全胸腔镜肺叶切除术在临床早期肺癌的应用价值. 上海医学, 2010, 33 (9):841-844.
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Byrn JC, Schluender S, Divino CM, et al. Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg, 2007, 193 (4):519-522.
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Louie BE, Farivar AS, Aye RW, et al. Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases. Ann Thorac Surg, 2012, 93 (5):1598-1604.
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刘伦旭. 胸腔镜肺癌切除:多样化的手术切口和流程. 医学与哲学:临床决策论坛版, 2011, 32 (9):11-13.
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许胜水, 段明科, 吴艺根, 等. 单向式全胸腔镜肺叶切除术治疗肺癌14例临床分析. 临床肺科杂志, 2011, 16 (1):80-81.
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吴良洪, 蒋清, 石珂, 等. 单向式肺叶切除术28例分析. 中华肺部疾病杂志:电子版, 2010, 03 (3):196-197.
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王述民, 侯维平, 滕洪, 等. 完全电视胸腔镜肺叶切除术24例临床治疗体会. 临床军医杂志, 2010, 38 (2):286-287.
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- 1. 刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24 (3):156-158.
- 2. 罗宜人, 王耀鹏, 王明钊, 等. 临床I期非小细胞肺癌电视胸腔镜肺叶切除术中淋巴结清扫的对照研究. 中国微创外科杂志, 2011, 11 (1):73-75.
- 3. 陈胜, 胡卫建, 谷电雷. 全胸腔镜肺叶切除治疗早期肺癌22例临床报道. 临床肺科杂志, 2012, 17 (3):499-500.
- 4. 陶显东, 潘铁文, 吴彬, 等. 电视胸腔镜手术在非小细胞肺癌治疗中的优势. 中华肺部疾病杂志:电子版, 2011, 04 (3):205-210.
- 5. 卜梁, 李运, 杨帆, 等. 直径大于5cm非小细胞肺癌患者行全胸腔镜肺叶切除手术与开胸手术疗效的对比研究. 北京大学学报:医学版, 2011, 43 (6):866-872.
- 6. 李凤卫, 姜冠潮, 李运, 等. 全胸腔镜与开胸肺叶切除治疗cNO-pN2非小细胞肺癌效果初步比较. 北京大学学报:医学版, 2011, 43 (6):861-865.
- 7. 李泽树, 杜波, 杨建国. 全胸腔镜下手术治疗26例早期肺癌的体会. 实用癌症杂志, 2010, 25 (6):607-608, 615.
- 8. 王如文, 邓波, 谭群友. 电视胸腔镜手术在肺癌治疗中有待解决的问题. 中华肺部疾病杂志:电子版, 2011, 04 (3):174-177.
- 9. 郭刚, 侯文俊, 李高峰, 等. 完全胸腔镜下肺叶切除术治疗非小细胞肺癌54例临床分析. 昆明医学院学报, 2011, 32 (9):24-27.
- 10. 胡定中, 林凌, 沈宇舟, 等. 全胸腔镜肺叶切除术在临床早期肺癌的应用价值. 上海医学, 2010, 33 (9):841-844.
- 11. Byrn JC, Schluender S, Divino CM, et al. Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg, 2007, 193 (4):519-522.
- 12. Louie BE, Farivar AS, Aye RW, et al. Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases. Ann Thorac Surg, 2012, 93 (5):1598-1604.
- 13. 刘伦旭. 胸腔镜肺癌切除:多样化的手术切口和流程. 医学与哲学:临床决策论坛版, 2011, 32 (9):11-13.
- 14. 许胜水, 段明科, 吴艺根, 等. 单向式全胸腔镜肺叶切除术治疗肺癌14例临床分析. 临床肺科杂志, 2011, 16 (1):80-81.
- 15. 吕宾, 胡德宏, 卢恒孝, 等. 全胸腔镜单向式肺叶切除在I/II期非小细胞肺癌治疗中的临床应用. 中华腔镜外科杂志:电子版, 2012, 5 (1):46-49.
- 16. 吴良洪, 蒋清, 石珂, 等. 单向式肺叶切除术28例分析. 中华肺部疾病杂志:电子版, 2010, 03 (3):196-197.
- 17. 王述民, 侯维平, 滕洪, 等. 完全电视胸腔镜肺叶切除术24例临床治疗体会. 临床军医杂志, 2010, 38 (2):286-287.