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目的探讨应用达芬奇机器人行非小细胞肺癌根治术的治疗效果。方法回顾性分析2012年1月至2015年1月于沈阳军区总医院胸外科治疗的202例非小细胞肺癌患者资料,其中80例患者(机器人组)行达芬奇机器人肺叶切除、淋巴结清扫术,122例患者(胸腔镜组)行胸腔镜肺叶切除、淋巴结清扫术。比较两组的淋巴结清扫情况及术后治疗效果。结果机器人组和胸腔镜组的淋巴结清扫数[(16.93±8.00)枚vs(13.98±8.67)枚]及淋巴结清扫组数[(4.89±1.57)组vs(4.25±1.23)组]、术后2年无进展生存率(71.2%vs 57.4%),Ⅰ期淋巴结清扫数[(16.59±8.57)枚vs(11.86±6.61)枚]、术后2年无进展生存率(84.3%vs 57.8%)及生存率(96.1%vs84.4%)比较,机器人组均优于胸腔镜组(P<0.05);机器人组和胸腔镜组的术中出血量[(57±49)ml vs(211±180)ml]及术后引流量[术后1 d为(255±116)ml vs(332±175)ml、术后2 d为(259±114)ml vs(321±172)ml]比较,机器人组均少于胸腔镜组(P<0.05);两组的其他指标比较,差异无统计学意义(P>0.05)。结论达芬奇机器人非小细胞肺癌手术在淋巴结清扫数量及中期术后疗效上略优于胸腔镜手术。
Objective To investigate the therapeutic effect of da Vinci robot in the treatment of non-small cell lung cancer. Methods The data of 202 patients with non-small cell lung cancer who underwent thoracic surgery at General Hospital of Shenyang Military Region from January 2012 to January 2015 were retrospectively analyzed. Among them, 80 patients (robot group) underwent levator apheresis and lymphadenectomy , 122 patients (thoracoscopic group) underwent thoracoscopic lobectomy, lymph node dissection. Lymphadenectomy and postoperative treatment were compared between the two groups. Results The number of lymph node dissection (16.93 ± 8.00 vs 13.98 ± 8.67) and the number of lymph node dissection group (4.89 ± 1.57 vs 4.25 ± 1.23 vs 4.25 ± 1.23) in the robot group and the thoracoscopic group were significantly different The rate of progression-free survival (71.2% vs 57.4%), stage Ⅰ lymph node dissection (16.59 ± 8.57 vs 11.86 ± 6.61), postoperative 2-year progression-free survival (84.3% vs 57.8% (57 ± 49) ml vs (211 ± 180) ml in robotic group and thoracoscopic group were significantly higher than those in thoracoscope group (96.1% vs84.4% ml] and postoperative drainage volume [(255 ± 116) ml vs (332 ± 175) ml at 1 day after operation and (259 ± 114) ml vs (321 ± 172) ml at 2 days after operation) (P <0.05). There was no significant difference in other indexes between the two groups (P> 0.05). Conclusion Da Vinci robotic non-small cell lung cancer surgery is slightly superior to thoracoscopic surgery in terms of the number of lymph node dissections and the postoperative efficacy.