■自2018年以来,机器人辅助胸外科(RATS)已广泛用于纵隔手术,当时它已被纳入日本的保险范围。很少有研究将RATS的手术结果与更成熟的电视胸腔镜手术(VATS)方法进行纵隔手术进行比较。我们旨在比较VATS和RATS的围手术期结局,以检查RATS方法在单个机构队列中的优势。
■在2014年至2022年期间,共纳入144例接受VATS的患者和46例接受RATS纵隔手术的患者。我们比较了临床病理特征,如年龄,性别,吸烟史,呼吸功能,外科领域,偏侧性,外科手术,外科医生的董事会认证,两组之间的组织学。围手术期结果包括手术时间,失血量,转换为开放手术的病例数,胸腔引流的持续时间,术后住院时间,术后并发症也进行了回顾。
■两组患者特征的比较显示,中位年龄存在显着差异(VATS,52.5年;大鼠,67.0年;P=0.001),联合切除肿瘤周围组织(VATS,2.1%;大鼠,10.9%;P=0.02),外科医生的董事会认证(VATS,53.5%;大鼠,100.0%;P<0.001),和组织学(RATS组胸腺上皮肿瘤的百分比更高,P=0.01)。关于围手术期结果,VATS组和RATS组的中位手术时间分别为120min和88min,差异显著(P=0.03)。失血量无显著差异,转换为开胸手术的发生率,胸腔引流的持续时间,术后住院时间,围手术期并发症发生率。在由董事会认证的外科医生手术的病例的围手术期结果中,中位手术时间(VATS,117分钟;大鼠,88分钟;P=0.02)和中位术后住院时间(VATS,7天;大鼠,6天;P=0.001)显示显着差异,而其他术后结局无显著差异。
■用于纵隔手术的RATS与VATS方法一样安全,并且可能导致更短的手术时间和术后住院时间。有必要在更大的队列中对纵隔手术的RATS进行进一步分析。
UNASSIGNED: Robot-assisted thoracic surgery (RATS) has become widely used for mediastinal procedures since 2018 when it was included in insurance coverage in Japan. Few studies have compared the surgical outcomes of RATS with the more established video-assisted thoracic surgery (VATS) approach to mediastinal surgery. We aimed to compare the perioperative outcomes of VATS and RATS to examine the advantages of the RATS approach in a single institutional cohort.
UNASSIGNED: A total of 144 patients who underwent VATS and 46 who underwent RATS mediastinal surgery between 2014 and 2022 were enrolled. We compared clinicopathological features such as age, sex, smoking history, respiratory function, surgical field, laterality, surgical procedure, board certification of the surgeon, and histology between the two groups. Perioperative outcomes including operation time, volume of blood lost, number of conversion cases to open surgery, duration of chest drainage, postoperative hospital stay, and postoperative complications were also reviewed.
UNASSIGNED: The comparison of patient characteristics between the groups showed significant differences in median age (VATS, 52.5 years; RATS, 67.0 years; P=0.001), combined resection of surrounding tissues of the tumor (VATS, 2.1%; RATS, 10.9%; P=0.02), board certification of the surgeon (VATS, 53.5%; RATS, 100.0%; P<0.001), and histology (RATS group had a higher percentage of thymic epithelial tumors, P=0.01). Regarding perioperative outcomes, the median operation time was 120 min in the VATS group and 88 min in the RATS group, showing a significant difference (P=0.03). There were no significant differences in the volume of blood lost, incidence of conversion to open chest surgery, duration of chest drainage, postoperative length of stay in hospital, and incidence of perioperative complications. In the perioperative outcomes of cases operated on by board-certified surgeons, the median operation time (VATS, 117 min; RATS, 88 min; P=0.02) and median postoperative length of stay in hospital (VATS, 7 days; RATS, 6 days; P=0.001) showed significant differences, while other postoperative outcomes were not significantly different.
UNASSIGNED: RATS for mediastinal surgery is as safe as the VATS approach and may result in a shorter operative time and postoperative hospital stay. Further analysis of RATS for mediastinal surgery in a larger cohort is warranted.