| Object:With the rapid development of surgical techniques and instruments,More and more patients with early-stage non-small cell lung cancer are being treated with minimally invasive surgery,including robot-assisted thoracoscopic surgery(RATS)and video-assisted thoracoscopic surgery(VATS).The purpose of this retrospective study was to compare the perioperative outcomes of patients undergoing radical lung cancer resection using single-operating-port robotic and thoracoscopic surgical approaches,and to evaluate the effectiveness and safety of thoracoscopic surgery for lung cancer with the single-operating-port Da Vinci surgical system.Methods:Clinical data of patients with non-small cell lung cancer who underwent surgical treatment and postoperative pathology showed lung malignancy were collected and analyzed from January 2021 to December 2021 in the thoracic surgery Department of the East Hospital of Qingdao Municipal Hospital.A total of 180 patients were included in the study.They were divided into two groups according to the surgical method: Da Vinci robot group(59 patients)and thoracoscopic assisted group(121patients).According to the patients’ gender,age,BMI,smoking history,family history,underlying diseases,lung function,tumor location,maximum tumor diameter,pathological type,pathological stage and other factors,propensity score matching was performed in SPSS 25.0.After propensity score matching,54 patients in each group were included in the study.The k nearest neighbor classification algorithm was used for matching,the caliper value was 0.02,the ratio was 1∶1,and there were replacement propensity scores to match the balance bias between groups,and two approximately randomized groups were obtained.Common Chi-square test was used for gender,smoking history,family history,etc.,and independent sample t test was used to compare continuous variables consistent with normal distribution such as drainage volume on the first day after surgery,postoperative catheter time,operative time,and intraoperative blood loss between groups.To analyze and compare the clinical baseline data,perioperative period and other related indexes between RATS and VATS group(P<0.05).Result:Among the 108 patients,44 were male and 64 were female,with an average age of 60.69±10.10,ranging from 31 to 82.There were no statistically significant differences in clinical data such as age,gender,smoking history,family history,height,weight,BMI,lung function,tumor location,underlying diseases,pathological types and maximum tumor diameter between the two groups after matching propensity scores(P>0.05).There was no perioperative death or intraoperative thoracotomy in both groups.In the thoracoscopic group,there was 1 case of chylothorax and 1 case of atrial fibrillation.Between RATS and VATS,postoperative pain score [(2.31±1.32)vs.(2.52±1.46),P=0.448],drainage volume on the first day after surgery [(102.31±70.22)ml vs.(94.26±96.48)ml,P=0.621],postoperative catheter time [(2.72±2.24)d vs.(2.46±1.36)d,P=0.468],operative time [(113.46±32.22)min vs.(102.69±35.97)min,P=0.104],intraoperative blood loss [(17.41±15.92)ml vs.(27.04±70.96)ml,P=0.333],postoperative hospital stay [(4.26±2.13)d vs.(4.56±1.44)d,P=0.399],number of lymph node dissection stations [(4.48±1.60)vs.(4.89±1.71),P=0.204],number of lymph node dissection [(8.59±5.33)vs.(10.76±6.13),P=0.053],incidence of postoperative complications [22.2%vs.27.8%,P=0.505] were not statistically significant.Conclusion:The perioperative results of single-operating-hole robot-assisted radical lung cancer are similar to those of video-assisted thoracoscopic radical lung cancer.Single-operating-hole robot-assisted radical lung cancer is safe and effective in the treatment of patients with non-small cell lung cancer.With the mastery of the Da Vinci robotic system and surgical procedures and the optimization of operational procedures,we believe that in the near future,more patients will benefit from the single-operating-hole Da Vinci robotic surgery. |
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