da Vinci robot system for radical surgery of lung cancer in elderly patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Shengliang , GUO Tiankang , BAI Qizhou ,  GOU Yunjiu , YU Jun , HAN Songchen

Department of Thoracic Surgery, Gansu Provincial Hospital, Lanhzhou, 730000, P.R.China;

Corresponding author：

GOU Yunjiu, Email: gouyunjiu@163.com

Keywords：

da Vinci robot system; elderly patients; radical surgery of lung cancer

DOI：

10.7507/1007-4848.202011093

Video：

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Objective To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer.Methods We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019. These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery (VATS) group according to the patients’ selection of the treatments. There were 32 patients with 20 males and 12 females aged 73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group. The clinical data of the two groups were compared.Results There was no statistical difference in surgery time between the two groups (t=–0.341, P=0.484). Compared with the VATS group, the da Vinci robot group had more number of lymph nodes dissected (t=1.635, P=0.015), less intraoperative blood loss (t=–2.569, P <0.001), less postoperative drainage amount within 3 days after surgery (t=–6.325, P=0.045), lower visual analogue scale (VAS) scores at postoperative 3rd day (t=–7.214, P=0.021).Conclusion The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.

Citation： HE Shengliang, GUO Tiankang, BAI Qizhou, GOU Yunjiu, YU Jun, HAN Songchen. da Vinci robot system for radical surgery of lung cancer in elderly patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(5): 514-518. doi: 10.7507/1007-4848.202011093 Copy

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5.	郑华, 仝丽, 胡瑛, 等. 408例70岁以上老年肺癌患者的预后因素分析. 中国肺癌杂志, 2011, 14(6): 502-506.
6.	Wei S, Chen M, Chen N, et al. Feasibility and safety of robot-assisted thoracic surgery for lung lobectomy in patients with non-small cell lung cancer: A systematic review and meta-analysis. World J Surg Oncol, 2017, 15(1): 98.
7.	Veronesi G, Park B, Cerfolio R, et al. Robotic resection of stage Ⅲ lung cancer: An international retrospective study. Eur J Cardiothorac Surg, 2018, 54(5): 912-919.
8.	Song CY, Sakai T, Kimura D, et al. Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage ⅠA non-small cell lung cancer: A propensity score matching study. J Thorac Dis, 2018, 10(8): 4891-4901.
9.	Mahieu J, Rinieri P, Bubenheim M, et al. Robot-assisted thoracoscopic surgery versus video-assisted thoracoscopic surgery for lung lobectomy: Can a robotic approach improve short-term outcomes and operative safety? Thorac Cardiovasc Surg, 2016, 64(4): 354-362.
10.	Melfi FM, Ambrogi MC, Lucchi M, et al. Video robotic lobectomy. Multimed Man Cardiothorac Surg, 2005, 2005(628): mmcts. 2004.000448.
11.	Chen D, Tan Q. Comment on "robotic versus video-assisted lobectomy/segmentectomy for lung cancers-A meta-analysis". Ann Surg, 2019, 270(6): e147-e148.
12.	Nelson DB, Mehran RJ, Mitchell KG, et al. Robotic-assisted lobectomy for non-small cell lung cancer: A comprehensive institutional experience. Ann Thorac Surg, 2019, 108(2): 370-376.
13.	代锋, 许世广, 徐惟, 等. 达芬奇机器人与电视胸腔镜辅助非小细胞肺癌根治术近期疗效配对的病例对照研究. 中国肺癌杂志, 2018, 21(3): 206-211.
14.	Casiraghi M, Spaggiari L. Robotic resection of stage Ⅲ lung cancer: An international retrospective study. J Thorac Dis, 2018, 10(Suppl 26): S3081-S3083.
15.	Amsbaugh MJ, Yusuf MB, Gaskins J, et al. Patterns of care and predictors of adjuvant therapies in elderly patients with glioblastoma: An analysis of the National Cancer Data Base. Cancer, 2017, 123(17): 3277-3284.
16.	Demir A, Ayalp K, Ozkan B, et al. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
17.	Burfeind WR, Jaik NP, Villamizar N, et al. A cost-minimisation analysis of lobectomy: Thoracoscopic versus posterolateral thoracotomy. Eur J Cardiothorac Surg, 2010, 37(4): 827-832.
18.	Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: Retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg, 2013, 8: 153.
19.	Yin HH, Tse MM, Wong FK. Postoperative pain experience and barriers to pain management in Chinese adult patients undergoing thoracic surgery. J Clin Nurs, 2012, 21(9-10): 1232-1243.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2. Cao C, Zhu ZH, Yan TD, et al. Video-assisted thoracic surgery versus open thoracotomy for non-small-cell lung cancer: A propensity score analysis based on a multi-institutional registry. Eur J Cardiothorac Surg, 2013, 44(5): 849-854.
3. Hirai K, Takeuchi S, Usuda J. Single-incision thoracoscopic surgery and conventional video-assisted thoracoscopic surgery: A retrospective comparative study of perioperative clinical outcomes. Eur J Cardiothorac Surg, 2016, 49 (Suppl 1): i37-i41.
4. 芮萌, 方庭正, 段蕴铀, 等. 70岁以上老年肺癌患者预后多因素分析. 癌变畸变突变, 2014, 26(4): 270-273.
5. 郑华, 仝丽, 胡瑛, 等. 408例70岁以上老年肺癌患者的预后因素分析. 中国肺癌杂志, 2011, 14(6): 502-506.
6. Wei S, Chen M, Chen N, et al. Feasibility and safety of robot-assisted thoracic surgery for lung lobectomy in patients with non-small cell lung cancer: A systematic review and meta-analysis. World J Surg Oncol, 2017, 15(1): 98.
7. Veronesi G, Park B, Cerfolio R, et al. Robotic resection of stage Ⅲ lung cancer: An international retrospective study. Eur J Cardiothorac Surg, 2018, 54(5): 912-919.
8. Song CY, Sakai T, Kimura D, et al. Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage ⅠA non-small cell lung cancer: A propensity score matching study. J Thorac Dis, 2018, 10(8): 4891-4901.
9. Mahieu J, Rinieri P, Bubenheim M, et al. Robot-assisted thoracoscopic surgery versus video-assisted thoracoscopic surgery for lung lobectomy: Can a robotic approach improve short-term outcomes and operative safety? Thorac Cardiovasc Surg, 2016, 64(4): 354-362.
10. Melfi FM, Ambrogi MC, Lucchi M, et al. Video robotic lobectomy. Multimed Man Cardiothorac Surg, 2005, 2005(628): mmcts. 2004.000448.
11. Chen D, Tan Q. Comment on "robotic versus video-assisted lobectomy/segmentectomy for lung cancers-A meta-analysis". Ann Surg, 2019, 270(6): e147-e148.
12. Nelson DB, Mehran RJ, Mitchell KG, et al. Robotic-assisted lobectomy for non-small cell lung cancer: A comprehensive institutional experience. Ann Thorac Surg, 2019, 108(2): 370-376.
13. 代锋, 许世广, 徐惟, 等. 达芬奇机器人与电视胸腔镜辅助非小细胞肺癌根治术近期疗效配对的病例对照研究. 中国肺癌杂志, 2018, 21(3): 206-211.
14. Casiraghi M, Spaggiari L. Robotic resection of stage Ⅲ lung cancer: An international retrospective study. J Thorac Dis, 2018, 10(Suppl 26): S3081-S3083.
15. Amsbaugh MJ, Yusuf MB, Gaskins J, et al. Patterns of care and predictors of adjuvant therapies in elderly patients with glioblastoma: An analysis of the National Cancer Data Base. Cancer, 2017, 123(17): 3277-3284.
16. Demir A, Ayalp K, Ozkan B, et al. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
17. Burfeind WR, Jaik NP, Villamizar N, et al. A cost-minimisation analysis of lobectomy: Thoracoscopic versus posterolateral thoracotomy. Eur J Cardiothorac Surg, 2010, 37(4): 827-832.
18. Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: Retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg, 2013, 8: 153.
19. Yin HH, Tse MM, Wong FK. Postoperative pain experience and barriers to pain management in Chinese adult patients undergoing thoracic surgery. J Clin Nurs, 2012, 21(9-10): 1232-1243.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

da Vinci robot system for radical surgery of lung cancer in elderly patients

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