A Comparative Analysis Of The Short-term Efficacy Of Da Vinci Robot And Thoracoscopic Assisted Segmentectomy

Objective: The relative clinical indexes of Da Vinci robot-assisted segmentectomy and thoracoscopic segmentectomy were compared and analyzed,and the clinical application value of Da Vinci robot-assisted segmentectomy was preliminarily discussed.Methods: A retrospective analysis was performed on the clinical data of 101 patients who underwent pulmonary segmentectomy in China-Japan Union Hospital of Jilin University from January 2021 to January 2022.The patients were divided into two groups according to the surgical methods: 52 patients in the Da Vinci robot-assisted pulmonary segmentectomy group(RATS group)and 49 patients in the thoracoscopic assisted pulmonary segmentectomy group(VATS group).Clinical baseline data such as gender,age,history of diabetes,hypertension,cardiovascular and cerebrovascular diseases,arrhythmia,tumor,smoking,alcohol consumption,body mass index,MVV%,longest diameter of pulmonary nodules under CT,proportion of solid component(CTR)under CT,lobar differentiation,and pathological conditions were collected.SPSS was used to compare and analyze the perioperative data of the two groups of patients,including operation time,intraoperative blood loss,preoperative and postoperative hemoglobin change,24 h chest drainage,number of lymph node sampling stations,number of lymph node sampling,catheter duration,postoperative hospital stay,whether there was a second catheter,postoperative complications,hospitalization costs,etc.Results: Lung segmentectomy was successfully completed in both groups,and no conversion to thoracotomy or perioperative death occurred.The clinical baseline data of the two groups were compared,and the results showed no significant difference(P > 0.05).The perioperative data of the two groups were further analyzed.The results showed that the number of intraoperative blood loss(60.63±23.87vs45.27±17.24ml),number of lymph nodes sampled(9.10±2.191vs11.08±2.274),length of postoperative hospital stay(5.55±2.43vs4.63±2.17d),postoperative complications(38.8%vs17.3%),hospitalization cost(72768 ± 11682vs95865 ± 8446 yuan)(P <0.05),and other indicators except hospitalization cost showed that RATS were better than VATS.In the two groups,the operation time(89.76 ± 15.129vs91.21 ±12.064min),the change of hemoglobin before and after the operation(-8.86 ±7.83vs-9.12±7.27g/L),the chest drainage volume in 24h(235.41±88.07vs255.38±123.93ml),lymph node extraction There were no significant differences in the number of sampling stations(6.14 ± 1.258vs6.54 ± 0.828 stations),tube time(3.53 ±2.28vs2.85±1.30d)and secondary tube down(16.3%vs13.5%)(P > 0.05).Conclusion: Da Vinci robot-assisted segmentectomy is a safe and effective surgical method.Compared with thoracoscopic assisted segmentectomy,Da Vinci robot-assisted segmentectomy has the advantages of less intraoperative bleeding,more lymph node sampling,shorter postoperative hospital stay,fewer postoperative complications,etc.,but the hospitalization cost is higher.