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目的总结达芬奇机器人手术系统在胸外科的应用体验。方法回顾性分析2016年1~11月我院胸外科行肺叶切除和纵隔肿瘤切除33例患者的临床资料,其中男24例、女9例,年龄51.3(22~76)岁。肺叶切除18例,肺楔形切除+肺段切除11例,纵隔肿瘤切除4例。分别对患者手术时间、淋巴结清扫数、中转开胸数、严重并发症(包括特发性急性肺损伤、呼吸衰竭、支气管胸膜瘘)、术中死亡人数等指标进行数据处理分析。结果 33例患者肺叶切除18例,术后病理证实为恶性肿瘤9例,肺结核5例,支气管扩张症4例;肺楔形切除+肺段切除11例,术后病理证实为结核球8例,良性结节3例。肺部疾病手术时间90~210(130.7±50.6)min,淋巴结清扫6~28(18.0±12.2)枚,纵隔肿瘤手术时间60~90(78.3±32.9)min。所有患者均顺利完成手术,无严重并发症(特发性急性肺损伤、呼吸衰竭、支气管胸膜瘘),无中转开胸。结论达芬奇Si系统使微创技术有了新的生命力,为微创手术技术的进一步发展提供了可能。
Objective To summarize the experience of Da Vinci robotic surgery system in thoracic surgery. Methods The clinical data of 33 patients who underwent lobectomy and mediastinal tumor resection in our hospital from January to November 2016 were retrospectively analyzed. There were 24 males and 9 females, aged 51.3 (22 to 76 years). Lobectomy in 18 cases, pulmonary wedge resection + segmentectomy in 11 cases, mediastinal tumor resection in 4 cases. The data of operation time, number of lymphadenectomy, transfer thoracotomy, serious complications (including idiopathic acute lung injury, respiratory failure, bronchopleural fistula) and the number of intraoperative deaths were analyzed. Results There were 18 cases of lobectomy in 33 cases, 9 cases of malignant tumors, 5 cases of pulmonary tuberculosis, 4 cases of bronchiectasis, 11 cases of wedge resection and segmentectomy, 8 cases of tuberculoma confirmed by pathology, Nodules in 3 cases. Pulmonary disease operation time was 90 ~ 210 (130.7 ± 50.6) min, lymph node dissection 6 ~ 28 (18.0 ± 12.2) pieces, mediastinal tumor operation time 60 ~ 90 (78.3 ± 32.9) min. All patients were successfully completed surgery, no serious complications (idiopathic acute lung injury, respiratory failure, bronchopleural fistula), no transfer thoracotomy. Conclusion DaVinci Si system has made the minimally invasive technology has a new vitality, which provides the possibility for the further development of minimally invasive surgical techniques.