论文部分内容阅读
目的总结达芬奇机器人手术系统在胸外科纵隔肿瘤切除术中的应用经验。方法回顾分析2011年3月—2012月10月间,我科应用达芬奇机器人手术系统切除胸部纵隔肿瘤65例的临床资料。手术采用三臂法,即一个镜头臂z两个操作臂,不设辅助口,建立8 mmHg人工气胸。根据肿瘤的位置和大小等情况选择切口位置。对手术操作时间、术中出血量、术后拔管时间等情况进行统计分析,并对手术患者体位、如何选取适宜的手术切口部位进行总结。结果本组65例纵隔肿瘤中:实性肿瘤41例,囊肿24例。其中64例顺利应用达芬奇机器人手术系统完成肿瘤切除,1例联合电视胸腔镜系统顺利完成肿瘤切除术。手术时间为3~210(50.63±46.35)min,术中出血量为0~200(22.62+33.64)ml,胸引管拔出时间为术后第1~14(4.02±2.62)天。所有患者均恢复顺利出院。术后随访1~21(7.61±4.58)个月,所有患者目前恢复良好,无复发。结论应用达芬奇机器人手术系统治疗胸外科纵隔肿瘤,具有手术更加安全、术中出血量少、术后带管时间短、患者痛苦轻、住院时间短等优势。必要时,将达芬奇手术机器人系统与电视胸腔镜系统联合应用,可取得更佳的手术治疗效果。
Objective To summarize the application experience of Da Vinci robotic surgery system in thoracic surgery mediastinal tumor resection. Methods From March 2011 to October 2012, we retrospectively analyzed the clinical data of 65 cases of thoracic mediastinum tumor treated by Da Vinci robotic surgery system. Surgery using three-arm method, that is, a lens arm z two operating arm, no auxiliary port, the establishment of 8 mmHg artificial pneumothorax. According to the location and size of the tumor, etc. choose the location of incision. The operation time, intraoperative blood loss, extubation time and so on were statistically analyzed, and the position of surgical patients, how to select the appropriate surgical incision site to summarize. Results The group of 65 cases of mediastinal tumors: solid tumors in 41 cases, 24 cases of cysts. Among them, 64 cases were successfully treated with da Vinci robotic surgery system to complete tumor resection, 1 case combined with video-assisted thoracoscopic system successfully completed tumor resection. The operation time ranged from 3 to 210 (50.63 ± 46.35) min. The intraoperative blood loss ranged from 0 to 200 (22.62 + 33.64) ml. The duration of thoracic drainage was 1 to 14 days (4.02 ± 2.62) days after operation. All patients recovered successfully discharged. All cases were followed up for 1 ~ 21 (7.61 ± 4.58) months. All patients recovered well without recurrence. Conclusion Da Vinci robotic surgery system for the treatment of mediastinal thoracic thoracic surgery has the advantages of safer operation, less intraoperative blood loss, shorter postoperative period of laparotomy, less pain and shorter hospital stay. When necessary, the Da Vinci surgical robot system and video-assisted thoracoscopic system can be combined to achieve better surgical treatment.