Clinical analysis of the feasibility and safety of single utility port robot-assisted lung resection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

KANG Poming , LI Qingyuan , FANG Chunshu , TAO Shaolin , WU Licheng , DENG Bo , WANG Ruwen ,  TAN Qunyou

Department of Thoracic Surgery, Daping Hospital, Army Military Medical University, Chongqing, 400042, P. R. China;

Corresponding author：

TAN Qunyou, Email: tanqy001@163.com

Keywords：

Lung cancer; lung resection; robot-assisted thoracic surgery; anterior approach; single utility port surgery

DOI：

10.7507/1007-4848.202103074

Video：

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Objective To investigate the feasibility and safety of single utility port Da Vinci robot-assisted lung resection via anterior approach.Methods The clinical data of 21 patients who underwent single utility port Da Vinci robot-assisted lung resection from February to March 2021 were retrospectively analyzed. There were 10 males and 11 females, with a median age of 50 (34-66) years. The operation time, blood loss, postoperative hospitalization time, postoperative complications and other indicators were analyzed.Results All patients completed the operation successfully with no transition to thoracotomy or perioperative death. Overall surgery time was 103 (70-200) min, Docking time was 5 (3-10) min, operation time was 81 (65-190) min. The blood loss was 45 (20-300) mL. All patients had malignant tumors, the number of dissected lymph node station was 3 (1-6), and the number of lymph nodes was 5 (2-16). The postoperative indwelling time was 3 (2-5) d. The postoperative hospitalization time was 5 (3-7) d. The pain score for the first 3 days after surgery was 3±1 points.Conclusion Single utility port robot-assisted lung resection via anterior approach is safe, less traumatic, more convenient and effective, which can be gradually promoted and applied to clinical trials.

Citation： KANG Poming, LI Qingyuan, FANG Chunshu, TAO Shaolin, WU Licheng, DENG Bo, WANG Ruwen, TAN Qunyou. Clinical analysis of the feasibility and safety of single utility port robot-assisted lung resection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(4): 430-435. doi: 10.7507/1007-4848.202103074 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Yang CJ, Kumar A, Deng JZ, et al. A national analysis of short-term outcomes and long-term survival following thoracoscopic versus open lobectomy for clinical stage Ⅱ non-small-cell lung cancer. Ann Surg, 2021, 273(3): 595-605.
3.	Aiolfi A, Nosotti M, Micheletto G, et al. Pulmonary lobectomy for cancer: Systematic review and network meta-analysis comparing open, video-assisted thoracic surgery, and robotic approach. Surgery, 2021, 169(2): 436-446.
4.	Wang Z, Pang L, Tang J, et al. Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: A systematic review and meta-analysis. BMC Surg, 2019, 19(1): 144.
5.	Long H, Tan Q, Luo Q, et al. Thoracoscopic surgeryversus thoracotomy for lung cancer: Short-term outcomes of a randomized trial. Ann Thorac Surg, 2018, 105(2): 386-392.
6.	Abbas AE. Surgical management of lung cancer: History, evolution, and modern advances. Curr Oncol Rep, 2018, 20(12): 98.
7.	Kneuertz PJ, Cheufou DH, D'Souza DM, et al. Propensity-score adjusted comparison of pathologic nodal upstaging by robotic, video-assisted thoracoscopic, and open lobectomy for non-small cell lung cancer. J Thorac Cardiovasc Surg, 2019, 158(5): 1457-1466.
8.	Leal Ghezzi T, Campos Corleta O. 30 years of robotic surgery. World J Surg, 2016, 40(10): 2550-2557.
9.	陈香, 韩宇, 张亚杰, 等. 机器人手术系统在不同分期肺癌根治术中的应用. 机器人外科学杂志(中英文), 2021, 2(1): 10-16.
10.	王述民. 达芬奇机器人在肺癌根治术中的应用现状及展望. 中国肿瘤, 2014, 23(9): 736-742.
11.	Toker A, Özyurtkan MO, Kaba E, et al. Robotic anatomic lung resections: The initial experience and description of learning in 102 cases. Surg Endosc, 2016, 30(2): 676-683.
12.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
13.	罗清泉, 李鹤成, 胡坚, 等. 机器人辅助肺癌手术中国临床专家共识. 中国胸心血管外科临床杂志, 2020, 27(10): 1119-1126.
14.	张树亮, 郑斌, 郭飞龙, 等. 单孔全胸腔镜在老年非小细胞肺癌患者中的应用. 中华胸部外科电子杂志, 2020, 7(3): 159-163.
15.	王帅, 张淼, 张辉, 等. 单孔与三孔单向式胸腔镜肺叶切除术的回顾性队列研究. 中国胸心血管外科临床杂志, 2020, 27(6): 663-668.
16.	Zhang M, Liu D, Wu W, et al. Preoperative 3D-CT bronchography and angiography facilitates single-direction uniportal thoracoscopic anatomic lobectomy. Ann Transl Med, 2019, 7(20): 526.
17.	Berfield KS, Farjah F, Mulligan MS. Video-assisted thoracoscopic lobectomy for lung cancer. Ann Thorac Surg, 2019, 107(2): 603-609.
18.	Abouarab AA, Rahouma M, Kamel M, et al. Single versus multi-incisional video-assisted thoracic surgery: A systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A, 2018, 28(2): 174-185.
19.	Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg, 2016, 5(2): 76-84.
20.	Gezer S, Avcı A, Türktan M. Cusum analysis for learning curve of videothoracoscopic lobectomy. Open Med (Wars), 2016, 11(1): 574-577.
21.	Veronesi G, Novellis P, Voulaz E, et al. Robot-assisted surgery for lung cancer: State of the art and perspectives. Lung Cancer, 2016, 101: 28-34.
22.	Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
23.	李青元, 陶绍霖, 康珀铭, 等. 机器人与胸腔镜肺叶切除对非小细胞肺癌患者机体创伤及淋巴细胞亚群的影响. 中国胸心血管外科临床杂志, 2021, 28(3): 299-304.
24.	Yang Y, Song L, Huang J, et al. A uniportal right upper lobectomy by three-arm robotic-assisted thoracoscopic surgery using the Da Vinci (Xi) surgical system in the treatment of early-stage lung cancer. Transl Lung Cancer Res, 2021, 10(3): 1571-1575.
25.	陶绍霖, 李青元, 康珀铭, 等. 经前侧入路机器人辅助肺叶切除术 180 例临床分析. 中国胸心血管外科临床杂志, 2020, 27(10): 1140-1144.
26.	Agzarian J, Fahim C, Shargall Y, et al. The use of robotic-assisted thoracic surgery for lung resection: A comprehensive systematic review. Semin Thorac Cardiovasc Surg, 2016, 28(1): 182-192.
27.	Cerfolio RJ, Bess KM, Wei B, et al. Incidence, results, and our current intraoperative technique to control major vascular injuries during minimally invasive robotic thoracic surgery. Ann Thorac Surg, 2016, 102(2): 394-399.
28.	Soliman BG, Nguyen DT, Chan EY, et al. Impact of Da Vinci Xi robot in pulmonary resection. J Thorac Dis, 2020, 12(7): 3561-3572.
29.	Kim MP, Nguyen DT, Meisenbach LM, et al. Da Vinci Xi robot decreases the number of thoracotomy cases in pulmonary resection. J Thorac Dis, 2019, 11(1): 145-153.
30.	Abdel Raheem A, Sheikh A, Kim DK, et al. Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: Preliminary experience. J Robot Surg, 2017, 11(1): 53-61.
31.	Alhossaini RM, Altamran AA, Choi S, et al. Similar operative outcomes between the Da Vinci Xi ® and Da Vinci Si ® systems in robotic gastrectomy for gastric cancer. J Gastric Cancer, 2019, 19(2): 165-172.
32.	Morelli L, Guadagni S, Di Franco G, et al. Use of the new Da Vinci Xi® during robotic rectal resection for cancer: A pilot matched-case comparison with the Da Vinci Si®. Int J Med Robot, 2017, 13: e1728.
33.	中华医学会胸心血管外科学分会胸腔镜外科学组, 中国医师协会胸外科医师分会微创胸外科专家委员会. 中国胸腔镜肺叶切除临床实践指南. 中华医学杂志, 2018, 98(47): 3832-3841.
34.	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.
35.	Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
36.	Lin XM, Yang Y, Chi C, et al. Video-assisted thoracoscopic lobectomy: Single-direction thoracoscopic lobectomy. J Thorac Dis, 2013, 5(5): 716-720.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Yang CJ, Kumar A, Deng JZ, et al. A national analysis of short-term outcomes and long-term survival following thoracoscopic versus open lobectomy for clinical stage Ⅱ non-small-cell lung cancer. Ann Surg, 2021, 273(3): 595-605.
3. Aiolfi A, Nosotti M, Micheletto G, et al. Pulmonary lobectomy for cancer: Systematic review and network meta-analysis comparing open, video-assisted thoracic surgery, and robotic approach. Surgery, 2021, 169(2): 436-446.
4. Wang Z, Pang L, Tang J, et al. Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: A systematic review and meta-analysis. BMC Surg, 2019, 19(1): 144.
5. Long H, Tan Q, Luo Q, et al. Thoracoscopic surgeryversus thoracotomy for lung cancer: Short-term outcomes of a randomized trial. Ann Thorac Surg, 2018, 105(2): 386-392.
6. Abbas AE. Surgical management of lung cancer: History, evolution, and modern advances. Curr Oncol Rep, 2018, 20(12): 98.
7. Kneuertz PJ, Cheufou DH, D'Souza DM, et al. Propensity-score adjusted comparison of pathologic nodal upstaging by robotic, video-assisted thoracoscopic, and open lobectomy for non-small cell lung cancer. J Thorac Cardiovasc Surg, 2019, 158(5): 1457-1466.
8. Leal Ghezzi T, Campos Corleta O. 30 years of robotic surgery. World J Surg, 2016, 40(10): 2550-2557.
9. 陈香, 韩宇, 张亚杰, 等. 机器人手术系统在不同分期肺癌根治术中的应用. 机器人外科学杂志(中英文), 2021, 2(1): 10-16.
10. 王述民. 达芬奇机器人在肺癌根治术中的应用现状及展望. 中国肿瘤, 2014, 23(9): 736-742.
11. Toker A, Özyurtkan MO, Kaba E, et al. Robotic anatomic lung resections: The initial experience and description of learning in 102 cases. Surg Endosc, 2016, 30(2): 676-683.
12. Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
13. 罗清泉, 李鹤成, 胡坚, 等. 机器人辅助肺癌手术中国临床专家共识. 中国胸心血管外科临床杂志, 2020, 27(10): 1119-1126.
14. 张树亮, 郑斌, 郭飞龙, 等. 单孔全胸腔镜在老年非小细胞肺癌患者中的应用. 中华胸部外科电子杂志, 2020, 7(3): 159-163.
15. 王帅, 张淼, 张辉, 等. 单孔与三孔单向式胸腔镜肺叶切除术的回顾性队列研究. 中国胸心血管外科临床杂志, 2020, 27(6): 663-668.
16. Zhang M, Liu D, Wu W, et al. Preoperative 3D-CT bronchography and angiography facilitates single-direction uniportal thoracoscopic anatomic lobectomy. Ann Transl Med, 2019, 7(20): 526.
17. Berfield KS, Farjah F, Mulligan MS. Video-assisted thoracoscopic lobectomy for lung cancer. Ann Thorac Surg, 2019, 107(2): 603-609.
18. Abouarab AA, Rahouma M, Kamel M, et al. Single versus multi-incisional video-assisted thoracic surgery: A systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A, 2018, 28(2): 174-185.
19. Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg, 2016, 5(2): 76-84.
20. Gezer S, Avcı A, Türktan M. Cusum analysis for learning curve of videothoracoscopic lobectomy. Open Med (Wars), 2016, 11(1): 574-577.
21. Veronesi G, Novellis P, Voulaz E, et al. Robot-assisted surgery for lung cancer: State of the art and perspectives. Lung Cancer, 2016, 101: 28-34.
22. Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
23. 李青元, 陶绍霖, 康珀铭, 等. 机器人与胸腔镜肺叶切除对非小细胞肺癌患者机体创伤及淋巴细胞亚群的影响. 中国胸心血管外科临床杂志, 2021, 28(3): 299-304.
24. Yang Y, Song L, Huang J, et al. A uniportal right upper lobectomy by three-arm robotic-assisted thoracoscopic surgery using the Da Vinci (Xi) surgical system in the treatment of early-stage lung cancer. Transl Lung Cancer Res, 2021, 10(3): 1571-1575.
25. 陶绍霖, 李青元, 康珀铭, 等. 经前侧入路机器人辅助肺叶切除术 180 例临床分析. 中国胸心血管外科临床杂志, 2020, 27(10): 1140-1144.
26. Agzarian J, Fahim C, Shargall Y, et al. The use of robotic-assisted thoracic surgery for lung resection: A comprehensive systematic review. Semin Thorac Cardiovasc Surg, 2016, 28(1): 182-192.
27. Cerfolio RJ, Bess KM, Wei B, et al. Incidence, results, and our current intraoperative technique to control major vascular injuries during minimally invasive robotic thoracic surgery. Ann Thorac Surg, 2016, 102(2): 394-399.
28. Soliman BG, Nguyen DT, Chan EY, et al. Impact of Da Vinci Xi robot in pulmonary resection. J Thorac Dis, 2020, 12(7): 3561-3572.
29. Kim MP, Nguyen DT, Meisenbach LM, et al. Da Vinci Xi robot decreases the number of thoracotomy cases in pulmonary resection. J Thorac Dis, 2019, 11(1): 145-153.
30. Abdel Raheem A, Sheikh A, Kim DK, et al. Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: Preliminary experience. J Robot Surg, 2017, 11(1): 53-61.
31. Alhossaini RM, Altamran AA, Choi S, et al. Similar operative outcomes between the Da Vinci Xi ® and Da Vinci Si ® systems in robotic gastrectomy for gastric cancer. J Gastric Cancer, 2019, 19(2): 165-172.
32. Morelli L, Guadagni S, Di Franco G, et al. Use of the new Da Vinci Xi® during robotic rectal resection for cancer: A pilot matched-case comparison with the Da Vinci Si®. Int J Med Robot, 2017, 13: e1728.
33. 中华医学会胸心血管外科学分会胸腔镜外科学组, 中国医师协会胸外科医师分会微创胸外科专家委员会. 中国胸腔镜肺叶切除临床实践指南. 中华医学杂志, 2018, 98(47): 3832-3841.
34. 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.
35. Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
36. Lin XM, Yang Y, Chi C, et al. Video-assisted thoracoscopic lobectomy: Single-direction thoracoscopic lobectomy. J Thorac Dis, 2013, 5(5): 716-720.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of the feasibility and safety of single utility port robot-assisted lung resection

Abstract Full text Figures/Tables Video References Cited by

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