| Objective: To compare the safety and efficacy of thoracoscopic lobectomy with Da Vinci robot-assisted lobectomy in the treatment of lung cancer.Methods: Clinical data of 328 patients who underwent lobectomy in the Affiliated Hospital of Qingdao University from January 2017 to August 2018 were retrospectively analyzed.According to different surgical procedures,they were divided into two groups:the Da Vinci robot group(RVATS group)and the thoracoscope group(VATS group).Baseline data including age,gender,body mass index(BMI),common comorbidities(hypertension,diabetes,coronary heart disease,and chronic obstructive pulmonary disease),American Society of Anesthesiologists grade(ASA grade),lesion site,pathological type,and TNM stage were collected in 2 groups.The primary outcomes were one-year survival rate and the incidence of postoperative complications such as subcutaneous emphysema,arrhythmia,pulmonary leakage for more than 5 days,atelectasis,pulmonary infection,intestinal obstruction,and gastric retention.The secondary outcome indexes were postoperative hospital stay,operative time,anesthesia recovery time(time required for withdrawal of anaesthesia until the criteria for transfer out of anaesthesia recovery room are met),number of lymph node dissection stations,operative blood loss,postoperative thoracic drainage volume,drainage time and hospitalization treatment cost.Finally,SPSS23.0 software package was used to analyze and compare the baseline data and perioperative related indicators of patients in the two groups,and P < 0.05 on both sides was considered statistically significant.Results: In this study,167 patients were enrolled in the Da Vinci robot group(RVATS group)and 161 patients were enrolled in the general thoracoscopic group(VATS group),and there was no statistical difference in the basic information between the two groups with comparability(P>0.05).There was no significant difference in one-year survival rate between the two groups(P>0.05).The incidence of postoperative complications and blood loss in RVATS group were lower than those in VATS group(P< 0.05),and the operative time,anesthesia recovery time and hospitalization cost were higher than those in VATS group(all P < 0.05).There were no statistical differences in length of stay,number of lymph node dissection groups,postoperative thoracic drainage volume and drainage time between the two groups(P>0.05).Conclusion: Da Vinci robot-assisted lobectomy is superior to conventional thoracoscopic surgery in terms of postoperative complications and intraoperative blood loss,and do not reduce the one-year survival rate of patients after surgery.The effect is similar in terms of postoperative hospital stay,number of lymph node dissection stations,postoperative thoracic drainage volume and drainage time.Although the operation time and anesthesia recovery time are relatively long and the hospitalization cost is relatively high,with the continuous improvement of medical technology and the decrease of consumable cost,the Da Vinci robotic surgical operating system is expected to play an increasingly important role in the radical resection of lung cancer. |
