摘要
目的总结机器人左肺上叶切除术治疗非小细胞肺癌的初步经验。方法 2013年3~8月,沈阳军区总医院应用达芬奇机器人系统完成左肺上叶切除术和淋巴结清除术4例,其中男3例、女1例,年龄49~67（58.8±9.1）岁。手术采用全身麻醉、双腔气管内插管、右侧卧位、折刀位;我们采用三臂法,根据肺叶裂发育情况采用单向式或解剖式肺叶切除术。肺癌患者常规进行系统淋巴结清扫。结果 4例患者顺利完成左肺上叶切除术和淋巴结清除术,手术时间100~150 min,术中清扫淋巴结11~23枚,术中出血量30~80 ml。术后病理检查提示：4例均为腺癌。病理分期：ⅠA期2例,ⅢA期2例。所有患者均顺利拔除胸腔引流管。胸腔引流管留置时间13.5（6~20）d,无严重术后并发症发生。所有患者均顺利出院。随访10~15个月,无肿瘤进展、复发或转移。结论应用达芬奇机器人手术系统行左肺上叶切除术安全、可行。
Objective To summarize our initial experience in robot-assisted left upper lobectomy for nonsmall cell lung cancer. Methods Four 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. Results Four 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 in ⅠA stage and 2 patients in ⅢA 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. Conclusion Robot-assisted left upper lobectomy is safe and feasible for non-small cell lung cancer.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2015年第3期215-219,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
左肺上叶切除术
非小细胞肺癌
微创性
机器人
达芬奇手术系统
Left upper lobectomy
Non-small cell lung cancer
Minimally invasive
Robotics
da Vinci S surgical system
