Clinical analysis for the short-term outcome of Da Vinci robotic-assisted left upper lobectomy for lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TONG Liping , ZHENG Xiaoqing , DUAN Hongtao , LIU Honggang , DONG Xiaoping , ZHANG Yong ,  YAN Xiaolong

Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, P.R.China;

Corresponding?author：

YAN Xiaolong, Email: 47260934@qq.com

Keywords：

Lung cancer; minimally invasive; Da Vinci surgical system; left upper lobectomy

DOI：

10.7507/1007-4848.201905019

Video：

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Objective To summarize the clinical experience of Da Vinci robotic-assisted left upper lobectomy for treating lung cancer.Methods We retrospectively analyzed the perioperative data of 33 patients with primary lung cancer who underwent Da Vinci robotic-assisted left upper lobectomy between December 2016 and December 2018 in our hospital. Meanwhile, the perioperative data of 41 patients with lung cancer who underwent video-assisted thoracoscopic left upper lobectomy during the same period by the same surgeon were studied as a control group. The resection was followed by the principle of "from back down to front up" way. Systemic lymph node dissection including No.4-9 was performed for all patients.Results All patients received successful surgery with no case of conversion to thoracotomy and perioperative death. Comparing to video-assisted thoracoscopic surgery, the Da Vinci robotic-assisted left upper lobectomy had longer operating time (191.21±61.77 min vs. 154.51±38.81 min, P=0.003), more cost (82 307.75±11 859.03 yuan vs. 58 966.57±5 640.07 yuan, P=0.000), shorter chest tube duration (4.58±1.77 d vs. 5.41±1.52 d, P=0.031) and postoperative hospital stay (6.48±1.82 d vs. 7.66±2.12 d, P=0.014). However, there was no significant difference between the two groups regarding to blood loss, lymph node dissection, postoperative pain score, total chest drainage volume, chest drainage volume per day and the rate of pulmonary complications.Conclusion The Da Vinci robotic-assisted left upper lobectomy for treating lung cancer is safe and more minimally invasive, but more expensive.

Citation： TONG Liping, ZHENG Xiaoqing, DUAN Hongtao, LIU Honggang, DONG Xiaoping, ZHANG Yong, YAN Xiaolong. Clinical analysis for the short-term outcome of Da Vinci robotic-assisted left upper lobectomy for lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(2): 183-189. doi: 10.7507/1007-4848.201905019 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer Statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	Lemjabbar-Alaoui H, Hassan OU, Yang YW, et al. Lung cancer: biology and treatment options. Biochim Biophys Acta, 2015, 1856(2): 189-210.
3.	Novellis P, Alloisio M, Vanni E, et al. Robotic lung cancer surgery: review of experience and costs. J Vis Surg, 2017, 3: 39.
4.	史博文, 孫冰生, 岳東升, 等. 達芬奇手術系統與胸腔鏡在肺癌根治術中的對比分析. 腫瘤防治研究, 2018, 45(2): 91-95.
5.	Pardolesi A, Bertolaccini L, Brandolini J, et al. Four arms robotic-assisted pulmonary resection—left upper lobectomy: how to do it. J Vis Surg, 2018, 4: 109.
6.	Kent M, Wang T, Whyte R, et al. Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg, 2014, 97(1): 236-424.
7.	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.
8.	Veronesi G, Novellis P, Voulaz E, et al. Robot-assisted surgery for lung cancer: State of the art and perspectives. Lung Cancer, 2016, 101: 28-34.
9.	同李平, 鄭曉慶, 劉紅崗, 等. “雙微孔”的三孔胸腔鏡肺葉切除術200例臨床分析. 中國胸心血管外科臨床雜志, 2019, 26(4): 369-373.
10.	Tong L, Zheng X, Duan H, et al. The feasibility and efficacy of two micro-portal videoassisted thoracic surgery in pulmonary lobectomy for lung cancer. J Thorac Dis, 2018, 10(10): 5898-5903.
11.	Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer suegery. BMC Surg, 2015, 15: 38.
12.	李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2017, 21(4): 279-284.
13.	Detterdeck F, Molins L. Video-assisted thoracic surgery and open chest surgery in lung cancer treatment: present and future. J Vis Surg, 2016, 2: 173.
14.	Guerrero WG, Gonzalez-Rivas D. Multiportal video-assisted thoracic surgery, uniportal video-assisted thoracic surgery and minimally invasive open chest surgery-seletion criteria. J Vis Surg, 2017, 3: 56.
15.	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.
16.	McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
17.	王述民, 汪誠風. 淺談達芬奇機器人手術系統與電視胸腔鏡系統在胸外科肺葉切除術中優劣. 臨床軍醫雜志, 2016, 44(6): 551-555.
18.	Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology forthoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
19.	Mahieu J, Rinieri P, Bubenheim M, et al. Robot-assisted thoracoscopic surgery versus video-assisted thoracoscopic surgery for lung lobectomy:can a robotic approach improve short-term outcomes and operative safety? Thorac Cardiovasc Surg, 2015, 64(4): 354-362.
20.	Wei S, Chen M, Chen N, et al. Feasibility and safety of robot-assisted thoracicsurgery for lung lobectomy in patients with non-small cell lung cancer: a systematic review and meta-analysis. World J Surg Oncol, 2017, 15(1): 98.
21.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
22.	Louie BE, Farivar AS, Aye RW, et al. 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): 1598-1604.
23.	Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg, 2010, 140: 19-25.
24.	Toker A, Kaba E, Ayalp K, et al. Robotic lung resections: video-assisted thoracic surgery based approach. J Vis Surg, 2017, 3: 15.
25.	王述民, 童向東, 劉博, 等. 達芬奇機器人左肺上葉切除術和淋巴結清除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2015, 22(3): 215-219.
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.
27.	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.
28.	鄒衛, 許棟生, 蘇宜江, 等. 左肺上葉切除的血管處理. 中華胸心血管外科雜志志, 2006, 22(1): 57.
29.	許世廣, 劉星池, 王希龍, 等. 應用達芬奇機器人手術系統肺切除技術總結. 中華胸部外科電子雜志, 2016, 3(2): 77-82.
30.	龐作良, 吳斌, 高勝利, 等. 左肺上葉癌的外科治療. 新疆醫科大學學報, 2006, 29(10): 948-949.
31.	馬超, 孫耀光, 田文鑫, 等. 單操作孔全胸腔鏡左肺上葉切除術 246 例. 中國微創外科雜志, 2017, 17(8): 680-687.
32.	Duan H, Tong L, Zhu Y, et al. Secondary resection tracheal was facilitated in robot-assisted left pneumonectomy. J Thorac Dis, 2018, 10(12): 7005-7008.
33.	Reddy RM, Gorrepati ML, Oh DS, et al. Robotic-assisted versus thoracoscopic lobectomy outcomes from high-volume thoracic surgeons. Ann Thorac Surg, 2018, 106(3): 902-908.
34.	Agzarian J, Fahim C, Shargall Y, et al. The use of robotic-assisted thoracic surgery for lung resection: A comprehensive systematic review. Semin Thorac Cardiovasc Surg, 2016, 28(1): 182-192.
35.	Scott J. Swanson, Daniel L. Miller, Robert Joseph McKenna, et al Comparing robot-assisted thoracic surgical lobectomy with conventional video-assisted thoracic surgical lobectomy and wedge resection: Results from a multihospital database (Premier). J Thorac Cardiovasc Surg, 2014, 147: 929-937.
36.	馬繼龍, 金大成, 韓松辰, 等. 早期肺癌患者行達芬奇機器人與胸腔鏡肺癌根治術的病例對照研究. 中國胸心血管外科臨床雜志, 2019, 26(1): 48-52.
37.	代鋒, 許世廣, 徐惟, 等. 達芬奇機器人與電視胸腔鏡輔助非小細胞肺癌根治術近期療效配對的病例對照研究. 中國肺癌雜志, 2018, 21(3): 206-211.
38.	王述民. 達芬奇機器人在肺癌根治術中的應用現狀及展望. 中國腫瘤, 2014, 23(9): 736-742.

1. Chen W, Zheng R, Baade PD, et al. Cancer Statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Lemjabbar-Alaoui H, Hassan OU, Yang YW, et al. Lung cancer: biology and treatment options. Biochim Biophys Acta, 2015, 1856(2): 189-210.
3. Novellis P, Alloisio M, Vanni E, et al. Robotic lung cancer surgery: review of experience and costs. J Vis Surg, 2017, 3: 39.
4. 史博文, 孫冰生, 岳東升, 等. 達芬奇手術系統與胸腔鏡在肺癌根治術中的對比分析. 腫瘤防治研究, 2018, 45(2): 91-95.
5. Pardolesi A, Bertolaccini L, Brandolini J, et al. Four arms robotic-assisted pulmonary resection—left upper lobectomy: how to do it. J Vis Surg, 2018, 4: 109.
6. Kent M, Wang T, Whyte R, et al. Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg, 2014, 97(1): 236-424.
7. 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.
8. Veronesi G, Novellis P, Voulaz E, et al. Robot-assisted surgery for lung cancer: State of the art and perspectives. Lung Cancer, 2016, 101: 28-34.
9. 同李平, 鄭曉慶, 劉紅崗, 等. “雙微孔”的三孔胸腔鏡肺葉切除術200例臨床分析. 中國胸心血管外科臨床雜志, 2019, 26(4): 369-373.
10. Tong L, Zheng X, Duan H, et al. The feasibility and efficacy of two micro-portal videoassisted thoracic surgery in pulmonary lobectomy for lung cancer. J Thorac Dis, 2018, 10(10): 5898-5903.
11. Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer suegery. BMC Surg, 2015, 15: 38.
12. 李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2017, 21(4): 279-284.
13. Detterdeck F, Molins L. Video-assisted thoracic surgery and open chest surgery in lung cancer treatment: present and future. J Vis Surg, 2016, 2: 173.
14. Guerrero WG, Gonzalez-Rivas D. Multiportal video-assisted thoracic surgery, uniportal video-assisted thoracic surgery and minimally invasive open chest surgery-seletion criteria. J Vis Surg, 2017, 3: 56.
15. 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.
16. McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
17. 王述民, 汪誠風. 淺談達芬奇機器人手術系統與電視胸腔鏡系統在胸外科肺葉切除術中優劣. 臨床軍醫雜志, 2016, 44(6): 551-555.
18. Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology forthoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
19. Mahieu J, Rinieri P, Bubenheim M, et al. Robot-assisted thoracoscopic surgery versus video-assisted thoracoscopic surgery for lung lobectomy:can a robotic approach improve short-term outcomes and operative safety? Thorac Cardiovasc Surg, 2015, 64(4): 354-362.
20. Wei S, Chen M, Chen N, et al. Feasibility and safety of robot-assisted thoracicsurgery for lung lobectomy in patients with non-small cell lung cancer: a systematic review and meta-analysis. World J Surg Oncol, 2017, 15(1): 98.
21. Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
22. Louie BE, Farivar AS, Aye RW, et al. 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): 1598-1604.
23. Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg, 2010, 140: 19-25.
24. Toker A, Kaba E, Ayalp K, et al. Robotic lung resections: video-assisted thoracic surgery based approach. J Vis Surg, 2017, 3: 15.
25. 王述民, 童向東, 劉博, 等. 達芬奇機器人左肺上葉切除術和淋巴結清除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2015, 22(3): 215-219.
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.
27. 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.
28. 鄒衛, 許棟生, 蘇宜江, 等. 左肺上葉切除的血管處理. 中華胸心血管外科雜志志, 2006, 22(1): 57.
29. 許世廣, 劉星池, 王希龍, 等. 應用達芬奇機器人手術系統肺切除技術總結. 中華胸部外科電子雜志, 2016, 3(2): 77-82.
30. 龐作良, 吳斌, 高勝利, 等. 左肺上葉癌的外科治療. 新疆醫科大學學報, 2006, 29(10): 948-949.
31. 馬超, 孫耀光, 田文鑫, 等. 單操作孔全胸腔鏡左肺上葉切除術 246 例. 中國微創外科雜志, 2017, 17(8): 680-687.
32. Duan H, Tong L, Zhu Y, et al. Secondary resection tracheal was facilitated in robot-assisted left pneumonectomy. J Thorac Dis, 2018, 10(12): 7005-7008.
33. Reddy RM, Gorrepati ML, Oh DS, et al. Robotic-assisted versus thoracoscopic lobectomy outcomes from high-volume thoracic surgeons. Ann Thorac Surg, 2018, 106(3): 902-908.
34. Agzarian J, Fahim C, Shargall Y, et al. The use of robotic-assisted thoracic surgery for lung resection: A comprehensive systematic review. Semin Thorac Cardiovasc Surg, 2016, 28(1): 182-192.
35. Scott J. Swanson, Daniel L. Miller, Robert Joseph McKenna, et al Comparing robot-assisted thoracic surgical lobectomy with conventional video-assisted thoracic surgical lobectomy and wedge resection: Results from a multihospital database (Premier). J Thorac Cardiovasc Surg, 2014, 147: 929-937.
36. 馬繼龍, 金大成, 韓松辰, 等. 早期肺癌患者行達芬奇機器人與胸腔鏡肺癌根治術的病例對照研究. 中國胸心血管外科臨床雜志, 2019, 26(1): 48-52.
37. 代鋒, 許世廣, 徐惟, 等. 達芬奇機器人與電視胸腔鏡輔助非小細胞肺癌根治術近期療效配對的病例對照研究. 中國肺癌雜志, 2018, 21(3): 206-211.
38. 王述民. 達芬奇機器人在肺癌根治術中的應用現狀及展望. 中國腫瘤, 2014, 23(9): 736-742.

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Clinical analysis for the short-term outcome of Da Vinci robotic-assisted left upper lobectomy for lung cancer

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