58例达芬奇机器人系统辅助肺部手术的临床分析

Objective: To explore the safety, feasibility and clinical value of Da Vinci robot system-assisted pulmonary surgery. Methods: The clinical data of Da Vinci robot system-assisted pulmonary surgery in our department were collected retrospectively and analyzed. Results: From March 2016 to November 2017, we enrolled 58 patients (42 males and 16 females, mean age 59±11 years) for the robotic system-assisted pulmonary surgery at our hospital. All surgeries were successfully completed, which consisted of lobectomy in 41 cases, segmentectomy in 7 cases, pulmonary wedge-shaped resection in 6 cases, pulmonary sleeve resection in 2 cases, combined resection in 1 case, and wedge-shaped resection & segmentectomy in 1 case. The postoperative diagnosis was benign lesions in 17 cases, and lung cancer in 41 cases. The average operation time was 169.93±66.88 mins for lobectomy and 165.43±56.37 mins for segmentectomy. The lymph node resection ranged from 5 to 26 pieces (mean of 15.1±8.7 pieces). The postoperative drainage time ranged from 2 to 15 days (mean of 6.0±2.6 days) and hospitalization time was 2 to 21 days (mean of 7.95±3.23 days). All but one patient recovered smoothly and were discharged with the total cost ranging from 32 015.57 to 127 087.89 yuan (mean of 78 483.19±15 925.18 yuan). The patient with bronchopleural fistula after resection was successfully treated with lobectomy. Conclusion: Da Vinci robotic system-assisted pulmonary surgery can be performed successfully in a center with extensive experience in thoracoscopic surgery. It is safe, feasible and advantageous in some complex operations, but the relatively expensive cost is an important factor that affects its wide application.