ObjectiveTo summarize our initial experience in robot-assisted left upper lobectomy for non-small cell lung cancer. MethodsFour patients with non-small cell lung cancer underwent robot-assisted left upper lobectomy with da Vinci S surgical system (Intuitive Surgical, California) in General Hospital of Shenyang Military Area Command between March and August 2013. There were 3 male and 1 female patients, and their age was 58.8 years (range:49-67 years). We used general anesthesia with double lumens trachea cannula. The patients set in right lateral decubitus position with jackknife. We used 3 arms of the robot system. A single direction lobectomy procedure or an anatomic lobectomy procedure was used according to the differentiation of fissure. Systemic lymph node dissection was performed for all patients. ResultsFour patients with left upper lobectomy were completed with total robotic procedure without conversion. Postoperative pathological examination showed all the patients were of all adenocarcinoma with 2 patients inⅠA stage and 2 patients inⅢA stage. The range of operating time was 100-150 min, intraoperative blood loss was 30-80 ml and no blood transfusion was needed for the patients. The drainage time was 6-20 days. All of the 4 patients were discharged smoothly. The patients were followed up for 10-15 months without recurrence or metastasis. ConclusionRobot-assisted left upper lobectomy is safe and feasible for non-small cell lung cancer.
ObjectiveTo summarize the clinical experience of Da Vinci robotic-assisted left upper lobectomy for treating lung cancer.MethodsWe retrospectively analyzed the perioperative data of 33 patients with primary lung cancer who underwent Da Vinci robotic-assisted left upper lobectomy between December 2016 and December 2018 in our hospital. Meanwhile, the perioperative data of 41 patients with lung cancer who underwent video-assisted thoracoscopic left upper lobectomy during the same period by the same surgeon were studied as a control group. The resection was followed by the principle of "from back down to front up" way. Systemic lymph node dissection including No.4-9 was performed for all patients.ResultsAll patients received successful surgery with no case of conversion to thoracotomy and perioperative death. Comparing to video-assisted thoracoscopic surgery, the Da Vinci robotic-assisted left upper lobectomy had longer operating time (191.21±61.77 min vs. 154.51±38.81 min, P=0.003), more cost (82 307.75±11 859.03 yuan vs. 58 966.57±5 640.07 yuan, P=0.000), shorter chest tube duration (4.58±1.77 d vs. 5.41±1.52 d, P=0.031) and postoperative hospital stay (6.48±1.82 d vs. 7.66±2.12 d, P=0.014). However, there was no significant difference between the two groups regarding to blood loss, lymph node dissection, postoperative pain score, total chest drainage volume, chest drainage volume per day and the rate of pulmonary complications.ConclusionThe Da Vinci robotic-assisted left upper lobectomy for treating lung cancer is safe and more minimally invasive, but more expensive.
ObjectiveTo summarize the efficacy of robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in the treatment of left upper lobectomy for non-small cell lung cancer. MethodsThe clinical data of patients with non-small cell lung cancer who underwent left upper lobectomy with RATS or VATS in our center from January 2019 to October 2021 were retrospectively analyzed. The patients were divided into two groups according to surgical methods: a RATS group and a VATS group. The baseline clinical data and results were compared between the two groups. ResultsA total of 145 patients were included. There were 78 males and 67 females with a mean age of 59.9 years. There were 63 patients in the RATS group and 82 patients in the VATS group. There was no death within 30 days after operation in both groups. In the RATS group, the drainage volume on the second postoperative day (233.49±83.94 mL vs. 284.88±120.21 mL, P=0.003), total operative time (126.94±29.50 min vs. 181.59±61.51 min, P=0.000), intraoperative resection time of the left upper lobe (76.48±27.52 min vs. 107.23±47.84 min, P=0.000), intraoperative blood loss (P=0.000), and conversion rate to thoracotomy (P=0.018) were significantly better than those in the VATS group. The group (5.41±0.94 groups vs. 4.83±1.31 groups, P=0.002) and number (18.27±7.39 vs. 12.76±6.54, P=0.000) of dissected lymph nodes in the RATS group were significantly more than those in the VATS group. The differences in the drainage volume on the first day after operation, postoperative intubation time, postoperative hospital stay or postoperative complications between the two groups were not statistically significant (P>0.05). ConclusionThe application of RATS in the left upper lobectomy for non-small cell lung cancer is safe and feasible, and has obvious advantages over VATS.