肺叶切除术治疗原发性肺癌：机器人辅助胸外科手术与视频辅助胸外科手术围手术期和术后结果的比较

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-17 DOI:10.1007/s00595-025-03000-6

Harushi Ueno, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Yuta Kawasumi, Keita Nakanishi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa

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引用次数: 0

摘要

目的：本研究比较了机器人辅助胸外科手术（RATS）和视频辅助胸外科手术（VATS）肺叶切除术治疗原发性肺癌的围手术期和术后结果。方法：本回顾性队列研究纳入了2018年4月至2022年3月期间在名古屋大学医院接受RATS或VATS治疗的患者。倾向评分匹配用于平衡两组患者的特征。评估以下长期结局：3年总生存期（OS）、死亡原因、3年无病生存期（DFS）和复发模式。各种围手术期和术后结果作为短期结果进行检查。结果：经倾向评分匹配，每组纳入137例患者。结论：在肺癌肺叶切除术中，RATS显示出与VATS相当的长期预后。虽然RATS的手术时间较长，但与VATS相比，其出血量较少，开胸转换率较低，提示其是一种有益的手术入路。

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Lobectomy for primary lung cancer: a comparison of perioperative and postoperative outcomes between robot-assisted thoracic surgery and video-assisted thoracic surgery.

Purpose: This study compared the peri- and postoperative outcomes of robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) lobectomy for primary lung cancer.

Methods: This retrospective cohort study included patients who underwent RATS or VATS at Nagoya University Hospital between April 2018 and March 2022. Propensity score matching was used to balance patient characteristics between the two groups. The following long-term outcomes were assessed: the 3-year overall survival (OS), causes of death, 3-year disease-free survival (DFS), and recurrence patterns. Various peri- and postoperative outcomes were examined as short-term outcomes.

Results: After propensity score-matching, 137 patients were included in each group. RATS was associated with a longer operative time (median 180 vs. 144 min, p < 0.001), less blood loss (median 5 vs. 12 ml, p = 0.005), and a lower rate of conversion to open thoracotomy (1 [0.7%] vs. 10 [7.4%], p = 0.010) than VATS. The 3-year OS and DFS were comparable between the groups.

Conclusion: In lobectomy for lung cancer, RATS demonstrated long-term outcomes that were comparable to those of VATS. Although RATS has a longer operative time, it is associated with less blood loss and a lower conversion rate to open thoracotomy than VATS, suggesting that it is a beneficial surgical approach for patients.

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.