Clinical analysis of robot-assisted lobectomy through anterior approach in 180 patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TAO Shaolin , LI Qingyuan , KANG Poming , JIANG Bin , SHEN Cheng , FENG Yonggeng , FANG Chunshu , WU Licheng , DENG Bo , WANG Ruwen ,  TAN Qunyou

Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, P.R.China;

Corresponding?author：

TAN Qunyou, Email: tanqy001@163.com

Keywords：

Lung cancer; lobectomy; robot-assisted thoracic surgery; anterior approach

DOI：

10.7507/1007-4848.202007093

Video：

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Objective To evaluate the feasibility and clinical value of robot-assisted lobectomy through anterior approach.Methods We retrospectively analyzed the clinical data of 180 patients who underwent robot-assisted lobectomy through anterior approach in our hospital between April 2017 and February 2018. There were 97 males and 83 females, aged 59.5 (32.0-83.0) years. The clinical effects were analyzed.Results One patient was transferred to thoracotomy due to tumor invasion of adjacent blood vessels and injury to the blood vessels, and there was no perioperative death. There were 8.5 (1.0-35.0) dissected lymph nodes for each patient. The median operation time was 120 (50-360) min, including robot Docking time 5 (1-23) min and robot operation time 65 (7-270) min. The median blood loss was 50 (5-1 500) mL, 132 (73.3%) patients had malignant tumors and median drainage time was 5 (2-30) d. The mean postoperative pain score was 3.4±0.7 points and the postoperative hospital time was 8 (2-32) d. At the median follow-up of 24 months, 11 patients developed recurrence and metastasis, and 3 died.Conclusion Robot-assisted lobectomy through anterior approach is a safe and convenient operation method, which is worthy of clinical application.

Citation： TAO Shaolin, LI Qingyuan, KANG Poming, JIANG Bin, SHEN Cheng, FENG Yonggeng, FANG Chunshu, WU Licheng, DENG Bo, WANG Ruwen, TAN Qunyou. Clinical analysis of robot-assisted lobectomy through anterior approach in 180 patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(10): 1140-1144. doi: 10.7507/1007-4848.202007093 Copy

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16.	Park BJ, Flores RM, Rusch VW. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg, 2006, 131(1): 54-59.
17.	Cerfolio RJ, Bryant AS, Skylizard L, <italic>et al</italic>. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
18.	Xu S, Liu B, Meng H, <italic>et al</italic>. Technical points of the operative procedure for robotic-assisted lung resection and lymph node dissection. Ann Transl Med, 2015, 3(7): 97.
19.	羅清泉, 王述民, 李鶴成, 等. 機器人輔助肺癌手術中國臨床專家共識. 中國胸心血管外科臨床雜志, 2020. [Epub ahead of print].
20.	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.
21.	Cerfolio RJ, Bess KM, Wei B, <italic>et al</italic>. Incidence, results, and our current intraoperative technique to control major vascular injuries during minimally invasive robotic thoracic surgery. Ann Thorac Surg, 2016, 102(2): 394-399.
22.	陶紹霖, 康珀銘, 譚群友, 等. 經前側入路達芬奇機器人輔助肺段切除術的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(2): 178-182.

1. Leal Ghezzi T, Campos Corleta O. 30 years of robotic surgery. World J Surg, 2016, 40(10): 2550-2557.
2. Brooks P. Robotic-assisted thoracic surgery for early-stage lung cancer: A review. AORN J, 2015, 102(1): 40-49.
3. 羅清泉. 機器人外科手術系統在普胸外科中的應用. 上海醫學, 2011, 34(1): 10-11.
4. Melfi FM, Menconi GF, Mariani AM, <italic>et al</italic>. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
5. Oh DS, Tisol WB, Cesnik L, <italic>et al</italic>. Port strategies for robot-assisted lobectomy by high-volume thoracic surgeons: A nationwide survey. Innovations (Phila), 2019, 14(6): 545-552.
6. Li JT, Liu PY, Huang J, <italic>et al</italic>. Perioperative outcomes of radical lobectomies using robotic-assisted thoracoscopic technique vs. video-assisted thoracoscopic technique: retrospective study of 1, 075 consecutive p-stageⅠnon-small cell lung cancer cases. J Thorac Dis, 2019, 11(3): 882-891.
7. Alam NZ, Flores RM. Extended video-assisted thoracic surgery (VATS) lobectomy. Minerva Chir, 2016, 71(1): 67-71.
8. Berfield KS, Farjah F, Mulligan MS. Video-assisted thoracoscopic lobectomy for lung cancer. Ann Thorac Surg, 2019, 107(2): 603-609.
9. Veronesi G, Novellis P, Voulaz E, <italic>et al</italic>. Robot-assisted surgery for lung cancer: State of the art and perspectives. Lung Cancer, 2016, 101: 28-34.
10. Kneuertz PJ, Cheufou DH, D'Souza DM, <italic>et al</italic>. Propensity-score adjusted comparison of pathologic nodal upstaging by robotic, video-assisted thoracoscopic, and open lobectomy for non-small cell lung cancer. J Thorac Cardiovasc Surg, 2019, 158(5): 1457-1466.
11. Cerfolio RJ, Ghanim AF, Dylewski M, <italic>et al</italic>. The long-term survival of robotic lobectomy for non-small cell lung cancer: A multi-institutional study. J Thorac Cardiovasc Surg, 2018, 155(2): 778-786.
12. Veronesi G, Park B, Cerfolio R, <italic>et al</italic>. Robotic resection of stage Ⅲ lung cancer: an international retrospective study. Eur J Cardiothorac Surg, 2018, 54(5): 912-919.
13. Huang J, Li C, Li H, <italic>et al</italic>. Robot-assisted thoracoscopic surgery versus thoracotomy for c-N2 stage NSCLC: short-term outcomes of a randomized trial. Transl Lung Cancer Res, 2019, 8(6): 951-958.
14. 許世廣, 王述民. 做好達芬奇機器人肺葉切除手術前的準備工作—一個助手的經驗分享. 實用醫院臨床雜志, 2015, 12(1): 35-38.
15. Sasaki M, Hirai S, Kawabe M, <italic>et al</italic>. Triangle target principle for the placement of trocars during video-assisted thoracic surgery. Eur J Cardiothorac Surg, 2005, 27(2): 307-312.
16. Park BJ, Flores RM, Rusch VW. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg, 2006, 131(1): 54-59.
17. Cerfolio RJ, Bryant AS, Skylizard L, <italic>et al</italic>. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
18. Xu S, Liu B, Meng H, <italic>et al</italic>. Technical points of the operative procedure for robotic-assisted lung resection and lymph node dissection. Ann Transl Med, 2015, 3(7): 97.
19. 羅清泉, 王述民, 李鶴成, 等. 機器人輔助肺癌手術中國臨床專家共識. 中國胸心血管外科臨床雜志, 2020. [Epub ahead of print].
20. 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.
21. Cerfolio RJ, Bess KM, Wei B, <italic>et al</italic>. Incidence, results, and our current intraoperative technique to control major vascular injuries during minimally invasive robotic thoracic surgery. Ann Thorac Surg, 2016, 102(2): 394-399.
22. 陶紹霖, 康珀銘, 譚群友, 等. 經前側入路達芬奇機器人輔助肺段切除術的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(2): 178-182.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of robot-assisted lobectomy through anterior approach in 180 patients

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