Comparison of perioperative outcomes between hybrid uniportal robotic-assisted and uniportal video-assisted thoracoscopic surgery - A propensity score matching analysis.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Thoracic Medicine Pub Date : 2025-04-01 Epub Date: 2025-03-31 DOI:10.4103/atm.atm_236_24
Jun Chen, Yunfei Gao, Yueying Yang, Jianhu Chu, Xiaogang Li, Dongbo Luo
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引用次数: 0

Abstract

Background: To evaluate the perioperative outcomes of hybrid multi-arm robotic-assisted uniportal thoracoscopic surgery (H-URATS) using a laparoscopic stapling device, assess the safety and feasibility of the procedure, and summarize the surgical experience.

Methods: The Department of Thoracic Surgery at Xinjiang Tumor Hospital has performed over 100 H-URATS procedures using endoscopic staplers and the robotic surgery platform. We collected the clinical data and perioperative outcomes from patients undergoing Uniportal Video-assisted Thoracoscopic Surgery (UVATS) and H-URATS between January 2023 and August 2024. Propensity score matching (PSM) was conducted based on clinical characteristics and perioperative outcomes were compared between the two groups after matching.

Results: A total of 395 patients were included, with 109 in the H-URATS group and 286 in the UVATS group. After PSM, each group consisted of 92 patients. There were no significant differences between the H-URATS and UVATS groups in terms of chest drainage duration, postoperative hospital stay, conversion to thoracotomy rate, intensive care unit admission rate, postoperative complication rate, postoperative pathological types, or tumor TNM staging (P > 0.05). The H-URATS group had less intraoperative blood loss compared to the UVATS group (P < 0.001), and more lymph nodes (LNs) and LN stations were dissected in the H-URATS group (P < 0.001).

Conclusion: In terms of short-term results, our study confirms the safety and feasibility of H-URATS as a new minimally invasive technique. It combines the advantages of uniportal thoracoscopy and robotic surgery systems and demonstrates potential benefits in oncological outcomes and complex procedures such as segmentectomies.

单门静脉机器人辅助与单门静脉视频辅助胸腔镜手术围手术期疗效比较——倾向评分匹配分析。
背景:评价采用腹腔镜吻合器的混合型多臂机器人辅助单门胸腔镜手术(H-URATS)围手术期疗效,评估手术的安全性和可行性,总结手术经验。方法:新疆省肿瘤医院胸外科使用内镜吻合器和机器人手术平台进行了100多例H-URATS手术。我们收集了2023年1月至2024年8月期间接受单门视频辅助胸腔镜手术(UVATS)和H-URATS的患者的临床数据和围手术期结果。根据两组患者的临床特征进行倾向评分匹配(PSM),匹配后比较两组患者围手术期预后。结果:共纳入395例患者,其中H-URATS组109例,UVATS组286例。经PSM治疗后,每组92例。H-URATS组与UVATS组在胸引流时间、术后住院时间、转开胸率、重症监护病房入院率、术后并发症发生率、术后病理类型、肿瘤TNM分期等方面差异均无统计学意义(P < 0.05)。与UVATS组相比,H-URATS组术中出血量更少(P < 0.001), H-URATS组清扫淋巴结(LNs)和淋巴结站(LN)更多(P < 0.001)。结论:就短期效果而言,我们的研究证实了H-URATS作为一种新型微创技术的安全性和可行性。它结合了单门胸腔镜和机器人手术系统的优点,并在肿瘤预后和复杂手术(如节段切除术)中展示了潜在的益处。
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来源期刊
Annals of Thoracic Medicine
Annals of Thoracic Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-RESPIRATORY SYSTEM
CiteScore
4.10
自引率
4.30%
发文量
19
审稿时长
>12 weeks
期刊介绍: The journal will cover studies related to multidisciplinary specialties of chest medicine, such as adult and pediatrics pulmonology, thoracic surgery, critical care medicine, respiratory care, transplantation, sleep medicine, related basic medical sciences, and more. The journal also features basic science, special reports, case reports, board review , and more. Editorials and communications to the editor that explore controversial issues and encourage further discussion by physicians dealing with chest medicine.
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