Robot-assisted Left Upper Lobectomy and Lymph Node Dissection for Non-small Cell Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANGShu-min , TONGXiang-dong , LIUBo , LIBo , XUWei , LIUXing-chi , WANGTong , QUJia-qi ,  XUShi-guang

Department of Thoracic Surgery, General Hospital of Shenyang Military Area Command, Shenyang 110016, P. R. China;

Corresponding?author：

XUShi-guang, Email: oldmonitor73@163.com

Keywords：

Left upper lobectomy; Non-small cell lung cancer; Minimally invasive; Robotics; da Vinci S surgical system

DOI：

10.7507/1007-4848.20150061

Video：

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Objective To summarize our initial experience in robot-assisted left upper lobectomy for non-small cell lung cancer. Methods Four patients with non-small cell lung cancer underwent robot-assisted left upper lobectomy with da Vinci S surgical system (Intuitive Surgical, California) in General Hospital of Shenyang Military Area Command between March and August 2013. There were 3 male and 1 female patients, and their age was 58.8 years (range:49-67 years). We used general anesthesia with double lumens trachea cannula. The patients set in right lateral decubitus position with jackknife. We used 3 arms of the robot system. A single direction lobectomy procedure or an anatomic lobectomy procedure was used according to the differentiation of fissure. Systemic lymph node dissection was performed for all patients. Results Four patients with left upper lobectomy were completed with total robotic procedure without conversion. Postoperative pathological examination showed all the patients were of all adenocarcinoma with 2 patients inⅠ_A stage and 2 patients inⅢ_A stage. The range of operating time was 100-150 min, intraoperative blood loss was 30-80 ml and no blood transfusion was needed for the patients. The drainage time was 6-20 days. All of the 4 patients were discharged smoothly. The patients were followed up for 10-15 months without recurrence or metastasis. Conclusion Robot-assisted left upper lobectomy is safe and feasible for non-small cell lung cancer.

Citation： WANGShu-min, TONGXiang-dong, LIUBo, LIBo, XUWei, LIUXing-chi, WANGTong, QUJia-qi, XUShi-guang. Robot-assisted Left Upper Lobectomy and Lymph Node Dissection for Non-small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 215-219. doi: 10.7507/1007-4848.20150061 Copy

1.	何建行, 劉會平, 楊運有.電視胸腔鏡肺癌根治術5年臨床療效.中國胸心血管外科臨床雜志, 2002, 9(1):29-31.
2.	曾智理, 李單青, 李力, 等.電視胸腔鏡輔助小切口肺葉切除治療周圍性型肺癌.中國微創外科雜志, 2009, 9:694-695.
3.	王述民, 曲家騏, 侯維平, 等.完全電視胸腔鏡和胸腔鏡輔助小切口型肺葉切除術481例.中華胸心血管外科雜志, 2010, 26(9):310-311.
4.	劉倫旭.胸腔鏡肺癌切除:多樣化的手術切口和流程.醫學與哲學(臨床決策論壇版), 2011, 32(9):11-13.
5.	陳海泉.胸腔鏡下非小細胞肺癌的外科治療:一項原則和兩個基本點.醫學與哲學(臨床決策論壇版), 2011, 32(9):9-10, 33.
6.	李文濤, 姜格寧, 高文, 等.序貫式全胸腔鏡肺葉切除術的臨床應用.中華外科雜志, 2011, 49(5):468-469.
7.	梅建東, 蒲強, 劉倫旭, 等.全胸腔鏡支氣管袖式成形肺癌切除的流程設計與優化.四川大學學報(醫學版), 2013, 44(1):114-118.
8.	馬林, 劉倫旭, 蒲強, 等.電視胸腔鏡手術中縫線定位法在肺部非淺表小結節活檢和切除術中的應用.中國胸心血管外科臨床雜志, 2013, 20(6):735-737.
9.	朱彥杰, 楊永珠, 李文濤.全胸腔鏡下飛短切除書的臨床應用.當代醫學, 2013, 19(32):1-4.
10.	羅宜人, 王耀鵬, 王明釗, 等.臨床I期非小細胞肺癌電視胸腔鏡肺葉切除術中淋巴結清掃的對照研究.中國微創外科雜志, 2011, 11(1):73-75.
11.	陳勝, 胡衛建, 谷電雷.全胸腔鏡肺葉切除治療早期肺癌22例臨床報道.臨床肺科雜志, 2012, 17(3):499-500.
12.	陶顯東, 潘鐵文, 吳彬, 等.電視胸腔鏡手術在非小細胞肺癌治療中的優勢.中華肺部疾病雜志(電子版), 2011, 4(3):33-36.
13.	卜梁, 李運, 楊帆, 等.直徑大于5 cm非小細胞肺癌患者行全胸腔鏡肺葉切除手術與開胸手術療效的對比研究.北京大學學報(醫學版), 2011, 43(6):866-872.
14.	李鳳衛, 姜冠潮, 李運, 等.全胸腔鏡與開胸肺葉切除治療cN0-pN2非小細胞肺癌效果初步比較.北京大學學報(醫學版), 2011, 43(6):861-865.
15.	李澤樹, 杜波, 楊建國.全胸腔鏡下手術治療26例早期肺癌的體會.實用癌癥雜志, 2010, 25(6):607-608, 615.
16.	王如文, 鄧波, 譚群友.電視胸腔鏡手術在肺癌治療中有待解決的問題.中華肺部疾病雜志(電子版), 2011, 4(3):9-11.
17.	郭剛, 侯文俊, 李高峰, 等.完全胸腔鏡下肺葉切除術治療非小細胞肺癌54例臨床分析.昆明醫學院學報, 2011, 32(9):24-27.
18.	胡定中, 林凌, 沈宇舟, 等.全胸腔鏡肺葉切除術在臨床早期肺癌的應用價值.上海醫學, 2010, 33(9):841-844.
19.	何建行, 楊運有, 陳滿蔭, 等.胸腔鏡肺葉切除術.中華外科雜志, 1996, 34:73-75.
20.	鄒衛, 許棟生, 蘇宜江.左肺上葉切除的血管處理.中華胸心血管外科雜志, 2006, 22(1):57.
21.	劉奎, 李力元, 王茂龍, 等.胸腔鏡肺葉切除術難點體會.臨床肺科雜志, 2012, 17(7):1185-1186.
22.	Byrn JC, Schluender S, Divino CM, et al.Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System.Am J Surg, 2007, 193(4):519-522.
23.	Brian EL, Alexander SF, Aye RW.Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases.Ann Thorac Surg, 2012, 93(5):1598-1605.
24.	劉倫旭, 車國衛, 蒲強, 等.單向式全胸腔鏡肺葉切除術.中華胸心血管外科雜志, 2008, 24(3):156-158.
25.	許世廣, 童向東, 劉博, 等.機器人輔助胸腔鏡下肺葉切除術16例報告.中國微創外科雜志, 2013, 13(9):806-809.
26.	王述民, 許世廣, 童向東, 等.機器人肺葉切除術治療非小細胞肺癌.中國胸心血管外科臨床雜志, 2013, 20(3):308-311.

1. 何建行, 劉會平, 楊運有.電視胸腔鏡肺癌根治術5年臨床療效.中國胸心血管外科臨床雜志, 2002, 9(1):29-31.
2. 曾智理, 李單青, 李力, 等.電視胸腔鏡輔助小切口肺葉切除治療周圍性型肺癌.中國微創外科雜志, 2009, 9:694-695.
3. 王述民, 曲家騏, 侯維平, 等.完全電視胸腔鏡和胸腔鏡輔助小切口型肺葉切除術481例.中華胸心血管外科雜志, 2010, 26(9):310-311.
4. 劉倫旭.胸腔鏡肺癌切除:多樣化的手術切口和流程.醫學與哲學(臨床決策論壇版), 2011, 32(9):11-13.
5. 陳海泉.胸腔鏡下非小細胞肺癌的外科治療:一項原則和兩個基本點.醫學與哲學(臨床決策論壇版), 2011, 32(9):9-10, 33.
6. 李文濤, 姜格寧, 高文, 等.序貫式全胸腔鏡肺葉切除術的臨床應用.中華外科雜志, 2011, 49(5):468-469.
7. 梅建東, 蒲強, 劉倫旭, 等.全胸腔鏡支氣管袖式成形肺癌切除的流程設計與優化.四川大學學報(醫學版), 2013, 44(1):114-118.
8. 馬林, 劉倫旭, 蒲強, 等.電視胸腔鏡手術中縫線定位法在肺部非淺表小結節活檢和切除術中的應用.中國胸心血管外科臨床雜志, 2013, 20(6):735-737.
9. 朱彥杰, 楊永珠, 李文濤.全胸腔鏡下飛短切除書的臨床應用.當代醫學, 2013, 19(32):1-4.
10. 羅宜人, 王耀鵬, 王明釗, 等.臨床I期非小細胞肺癌電視胸腔鏡肺葉切除術中淋巴結清掃的對照研究.中國微創外科雜志, 2011, 11(1):73-75.
11. 陳勝, 胡衛建, 谷電雷.全胸腔鏡肺葉切除治療早期肺癌22例臨床報道.臨床肺科雜志, 2012, 17(3):499-500.
12. 陶顯東, 潘鐵文, 吳彬, 等.電視胸腔鏡手術在非小細胞肺癌治療中的優勢.中華肺部疾病雜志(電子版), 2011, 4(3):33-36.
13. 卜梁, 李運, 楊帆, 等.直徑大于5 cm非小細胞肺癌患者行全胸腔鏡肺葉切除手術與開胸手術療效的對比研究.北京大學學報(醫學版), 2011, 43(6):866-872.
14. 李鳳衛, 姜冠潮, 李運, 等.全胸腔鏡與開胸肺葉切除治療cN0-pN2非小細胞肺癌效果初步比較.北京大學學報(醫學版), 2011, 43(6):861-865.
15. 李澤樹, 杜波, 楊建國.全胸腔鏡下手術治療26例早期肺癌的體會.實用癌癥雜志, 2010, 25(6):607-608, 615.
16. 王如文, 鄧波, 譚群友.電視胸腔鏡手術在肺癌治療中有待解決的問題.中華肺部疾病雜志(電子版), 2011, 4(3):9-11.
17. 郭剛, 侯文俊, 李高峰, 等.完全胸腔鏡下肺葉切除術治療非小細胞肺癌54例臨床分析.昆明醫學院學報, 2011, 32(9):24-27.
18. 胡定中, 林凌, 沈宇舟, 等.全胸腔鏡肺葉切除術在臨床早期肺癌的應用價值.上海醫學, 2010, 33(9):841-844.
19. 何建行, 楊運有, 陳滿蔭, 等.胸腔鏡肺葉切除術.中華外科雜志, 1996, 34:73-75.
20. 鄒衛, 許棟生, 蘇宜江.左肺上葉切除的血管處理.中華胸心血管外科雜志, 2006, 22(1):57.
21. 劉奎, 李力元, 王茂龍, 等.胸腔鏡肺葉切除術難點體會.臨床肺科雜志, 2012, 17(7):1185-1186.
22. Byrn JC, Schluender S, Divino CM, et al.Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System.Am J Surg, 2007, 193(4):519-522.
23. Brian EL, Alexander SF, Aye RW.Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases.Ann Thorac Surg, 2012, 93(5):1598-1605.
24. 劉倫旭, 車國衛, 蒲強, 等.單向式全胸腔鏡肺葉切除術.中華胸心血管外科雜志, 2008, 24(3):156-158.
25. 許世廣, 童向東, 劉博, 等.機器人輔助胸腔鏡下肺葉切除術16例報告.中國微創外科雜志, 2013, 13(9):806-809.
26. 王述民, 許世廣, 童向東, 等.機器人肺葉切除術治療非小細胞肺癌.中國胸心血管外科臨床雜志, 2013, 20(3):308-311.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Robot-assisted Left Upper Lobectomy and Lymph Node Dissection for Non-small Cell Lung Cancer

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