Robot-assisted Thoracic Surgery-Initial Experience at National Taiwan University Hospital

前言：在單一醫學機構進行前瞻性研究，以評估達文西機器手臂輔助之胸腔手術的有效可行性。方法：在臺大醫院胸腔外科，從2012年2月至2012年7月的半年期間，利用達文西機器手臂輔助進行胸腔手術，並記錄相關資料進行分析研究。一共完成了一例胸腺瘤切除、10例肺葉切除、一例食道切除重建、一例食道良性腫瘤切除。結果：機器手臂接合時間（docking time）之中位數為10.5分鐘（範圍4－21分鐘），機器手臂操作時間（console time）之中位數為183分鐘（範圍72－327分鐘）。沒有病患需要轉換成傳統之胸腔鏡或腹腔鏡進行手術，但有一位病患需要轉換成開胸手術來完成出血的控制。術後併發症包括一例延長之肺部漏氣、一例心律不整、一例肌無力症的暫時性惡化；但沒有任何死亡病例發生。胸管留置天數之中位數為3天（範圍2－11天），住院天數之中位數為6天（範圍4－19天）。結論：在我們的初步經驗中，證實機器手臂輔助之胸腔手術是安全可行的。至於它是否有優於傳統開胸或胸腔鏡手術，仍需更長時間追蹤之前瞻性研究來證實。

關鍵字

胸腔手術；機器手臂輔助之手術

並列摘要

Purpose: We set up a prospective study to evaluate the efficacy of thoracic surgery using the da Vinci system in a single institution.Methods: We prospectively enrolled patients who underwent robot-assisted thoracic surgery at Nation-al Taiwan University Hospital during the period February 2012 to July 2012. The procedures performed and patient numbers were thymothymectomy [1], lobectomy [10], esophagectomy [1] and excision of esophageal tumor [1].Results: The median docking time of all procedures was 10.5 minutes (range, 4-21 minutes) and the median console time was 183 minutes (range, 72-327 minutes). No patient was converted to traditional laparoscopy or thoracoscopy, but 1 patient was converted to open surgery due to major bleeding. The postoperative morbidities included 1 prolonged air leak, 1 atrial fibrillation, and 1 worsening of myasthenia gravis. There was no mortality. The median drain tube duration was 3 days (range, 2-11 days), and the median hospital stay was 6 days (range, 4-19 days).Conclusion: Robot-assisted thoracic surgery proved to be feasible and safe in our initial series in a learning curve setting. A longer follow-up period and randomized controlled trials are necessary to evaluate a potential benefit over open and conventional VATS approaches.

並列關鍵字

thoracic surgery ； robot-assisted surgery

國際替代計量

Robot-assisted Thoracic Surgery-Initial Experience at National Taiwan University Hospital

全文下載

主題瀏覽