PDF(Pubmed)
Abstract：
BACKGROUND: Robotic-assisted thoracic surgery has been shown as a safe and feasible surgical procedure to treat a broad range of thoracic malignancies with a shorten hospital stay, a quicker return to normal daily activities and superior quality of life compared to open approach. Nonetheless, its utilization has predominantly been restricted to the average surgical intervention. In the latest years, given the technological improvements and the advanced skills of the \"robotic\" surgeons, this approach has been applied to more complex and challenging procedures (e.g., advanced stages/ after neoadjuvant therapies). The aim of this study is to show the results and the advantages of redo thoracic procedures performed with a robot-assisted approach.
METHODS: Retrospective analysis of a prospectively collected database (2017-2019). We analysed the first case series undergoing robotic approach (totally endoscopic) in patients who underwent previous surgery and/or radiotherapy for thoracic malignancies.
RESULTS: Nine patients (M/F =5/4) with a median age of 73 years underwent robotic procedures after previous radical surgery (n=6) or radiation therapy treatment (n=3). The mean time interval between the two interventions was 96.12 months (range, 7-444 months). The conversion rate was 0%. No postoperative death occurred. Only one complication arose (air leaking) treated conservatively. The median length of stay and chest tube duration were 5 days (range, 4-10 days) and 2 days (range, 2-5 days). The 30-, 60- and 90-day mortality was 0%. With a median follow-up of 10 months (range, 2-12 months), all patients are currently alive, disease free, and with an overall survival and a disease-free survival of 10 months.
CONCLUSIONS: The robotic surgery is a safe and feasible approach in case of redo-robotic surgery, showing good outcomes, permitting a fast return to full daily activity, and enabling the patients to rapidly undergo adjuvant treatments, when required.
METHODS: Retrospective analysis of a prospectively collected database (2017-2019). We analysed the first case series undergoing robotic approach (totally endoscopic) in patients who underwent previous surgery and/or radiotherapy for thoracic malignancies.
RESULTS: Nine patients (M/F =5/4) with a median age of 73 years underwent robotic procedures after previous radical surgery (n=6) or radiation therapy treatment (n=3). The mean time interval between the two interventions was 96.12 months (range, 7-444 months). The conversion rate was 0%. No postoperative death occurred. Only one complication arose (air leaking) treated conservatively. The median length of stay and chest tube duration were 5 days (range, 4-10 days) and 2 days (range, 2-5 days). The 30-, 60- and 90-day mortality was 0%. With a median follow-up of 10 months (range, 2-12 months), all patients are currently alive, disease free, and with an overall survival and a disease-free survival of 10 months.
CONCLUSIONS: The robotic surgery is a safe and feasible approach in case of redo-robotic surgery, showing good outcomes, permitting a fast return to full daily activity, and enabling the patients to rapidly undergo adjuvant treatments, when required.
摘要：
背景：机器人胸腔镜手术已被证明是一种安全可行的手术方法，可以缩短住院时间，治疗广泛的胸部恶性肿瘤，与开放式方法相比，更快地恢复正常的日常活动和卓越的生活质量。尽管如此，其使用主要限于平均手术干预。最近几年,鉴于“机器人”外科医生的技术改进和先进技能，这种方法已应用于更复杂和更具挑战性的程序(例如，晚期/新辅助治疗后)。这项研究的目的是展示使用机器人辅助方法进行重做胸部手术的结果和优势。
方法：对前瞻性收集的数据库（2017-2019年）进行回顾性分析。我们分析了在先前接受过胸部恶性肿瘤手术和/或放疗的患者中接受机器人方法（完全内窥镜）的第一个病例系列。
结果：9例患者（M/F=5/4），中位年龄73岁，在之前的根治性手术（n=6）或放射治疗（n=3）后接受了机器人手术。两种干预措施之间的平均时间间隔为96.12个月(范围，7-444个月）。转化率为0%。无术后死亡。保守治疗仅出现一种并发症（漏气）。中位住院时间和胸管持续时间为5天(范围，4-10天）和2天（范围，2-5天）。30-，60天和90天死亡率为0%。中位随访时间为10个月(范围，2-12个月),所有病人目前都还活着，无疾病,总生存期和无病生存期为10个月。
结论：在重做机器人手术的情况下，机器人手术是一种安全可行的方法，表现出良好的结果，允许快速恢复完整的日常活动，使患者能够迅速接受辅助治疗，当需要时。
方法：对前瞻性收集的数据库（2017-2019年）进行回顾性分析。我们分析了在先前接受过胸部恶性肿瘤手术和/或放疗的患者中接受机器人方法（完全内窥镜）的第一个病例系列。
结果：9例患者（M/F=5/4），中位年龄73岁，在之前的根治性手术（n=6）或放射治疗（n=3）后接受了机器人手术。两种干预措施之间的平均时间间隔为96.12个月(范围，7-444个月）。转化率为0%。无术后死亡。保守治疗仅出现一种并发症（漏气）。中位住院时间和胸管持续时间为5天(范围，4-10天）和2天（范围，2-5天）。30-，60天和90天死亡率为0%。中位随访时间为10个月(范围，2-12个月),所有病人目前都还活着，无疾病,总生存期和无病生存期为10个月。
结论：在重做机器人手术的情况下，机器人手术是一种安全可行的方法，表现出良好的结果，允许快速恢复完整的日常活动，使患者能够迅速接受辅助治疗，当需要时。
