| ObjectiveLung segmentectomy preserves more healthy lung tissue than lobectomy,so it has been widely used in clinical practice.At present,VATS is widely used in clinical practice.As the latest surgical technique,Robot-assisted thoracic surgery(RATS)is increasingly used in thoracic surgery.The purpose of this study was to compare the short-term outcomes of segmentectomy for stage ⅠA non-small cell lung cancer by two surgical methods.MethodsA retrospective analysis was performed on 101 patients with stage ⅠA non-small cell lung cancer and undergoing segmentectomy admitted to the Department of Thoracic Surgery of The General Hospital of the Northern Theater Command from July 2016 to July 2020.According to different surgical methods,they were divided into RATS group and VATS group.Among them,there were 50 patients with segmentectomy by Da Vinci robot,including 16 males and 34 females,with an average age of(59.98±10.77)years,average diameter of pulmonary nodules of(1.16±0.34)cm,11 patients with basic diseases complicated with hypertension,6 patients with diabetes,and 9 patients with coronary heart disease.Postoperative pathology showed 11 cases of adenocarcinoma in situ,17 cases of microinfiltrating adenocarcinoma,21 cases of infiltrating adenocarcinoma,and 1 case of squamous cell carcinoma.During the same period,51 patients underwent video-assisted thoracoscopic segmental pulmonary resection,including 19 males and 32 females,with an average age of(60.25±8.85)years,average diameter of pulmonary nodules of(1.24±0.31)cm,19 patients with basic diseases complicated with hypertension,5 patients with diabetes,and 7 patients with coronary heart disease.Postoperative pathology showed 5 cases of adenocarcinoma in situ,12 cases of microinfiltrating adenocarcinoma,32 cases of infiltrating adenocarcinoma,and2 case of squamous cell carcinoma.By collecting the clinical baseline data and perioperative data of the patients,the operation time,intraoperative blood loss,lymph node dissection stations,lymph node dissection number,drainage volume on the first day after the operation,total drainage volume on the third day after the operation,postoperative chest catheter insertion time,postoperative hospitalization days,and postoperative complication rate were compared and analyzed.ResultsPatients in both groups successfully completed pulmonary segmental resection,and there were no cases of conversion to thoracotomy and perioperative death.Compared and analyzed the postoperative clinical results of the two groups,the intraoperative blood loss [(34.40±12.96)ml vs.(85.10±26.41)ml,P=0.000],the number of lymph node dissection stations [(4.72±1.20)vs.(3.60±1.40),P=0.000] and the number of lymph node dissection [(15.14±5.91)vs.(10.76±5.26),P=0.000] showed statistically significant differences,and RATS group was superior to VATS group,RATS has better lymph node clearance and less intraoperative blood loss..There were no statistically significant differences in operation time [(153.90±21.88)min vs.(155.39±25.04)min,P=0.751],drainage volume on the first day after surgery[(217.80±76.94)ml vs.(210.98±86.98)ml,P=0.678],total drainage volume three days after surgery [(612.60±169.93)ml vs.(595.10±203.90)ml,P=0.641],duration of chest drainage tube after operation [(5.36±2.33)d vs.(5.18±2.54)d,P=0.706],postoperative hospitalization days[(7.50±2.35)d vs.(7.47±2.93)d,P=0.956]and postoperative complication incidence.ConclusionDa Vinci robot segmentectomy is a safe and effective surgical method,with less bleeding and more lymph node dissection stations and number than video-assisted thoracoscopic segmentectomy for stage ⅠA non-small cell lung cancer. |
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