The therapeutic effect of non-small cell lung cancer with da Vinci surgical(robot-assisted thoracic surgery) system

doi:10.3877/cma.j.issn.1674-6899.2017.02.009

Abstract

Abstract:

Objective

To investigate the treatment outcome of lobectomy for non-small cell lung cancer with da Vinci Surgical System.

Methods

From Jan. 2012 to Jan. 2015, 202 patients with non-small cell lung cancer underwent lobectomy and systematic node dissection. 80 patients underwent robot-assisted thoracic surgery(RATS) (RATS group) and 122 patients underwent video-assisted thoracic surgery(VATS) (VATS group). To compare and analyze the condition of lmphy nodes dissection and outcomes of patients in the two groups.

Results

There were significant difference between RATS group and VATS group in dissected total number of lmphy node [(16.93 ± 8.00) vs (13.98 ± 8.67)] and team [(4.89 ± 1.57) vs (4.25 ± 1.23)], the 2 years disease free survival rate (71.2% vs 57.4%), the dissected number of lmphy node of stage Ⅰ [(16.59 ± 8.57) vs (11.86 ± 6.61)], the 2 years disease free survival rate (84.3% vs 57.8%) and overall survival rate (96.1% vs 84.4%). There were also significant difference between two groups in blood loss [(57 ± 49)ml vs (211 ± 180)ml ], drainage volume [POD 1(255 ± 116)ml vs (332 ± 175) ml, POD 2(259 ± 114)ml vs (321 ± 172)ml ]. Whereas there were no significant difference between the two groups in other outcomes.

Conclusion

The RATS dissected more number of lmphy node and took better median outcomes than VATS in NSCLC.

Key words: Robot-assisted thoracic surgery, Video-assisted thoracic surgery, Lmphy nodes dissection, Non-small cell lung cancer, Overall survival, Disease free survival

Xingchi Liu, Shiguang Xu, Wei Xu, Bo Liu, Tong Wang, Bo Li, Xilong Wang, Hong Teng, Shumin Wang, Qifeng Mo, Qingyu Meng. The therapeutic effect of non-small cell lung cancer with da Vinci surgical(robot-assisted thoracic surgery) system[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2017, 10(02): 97-101.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2017.02.009

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2017/V10/I02/97

Figures/Tables 8

References 21

1	Alberg AJ, Brock MV, Ford JG, et al. Epidemiology of lung cancer: diagnosis and management of lung cancer, 3rd ed: american college of chest physicians evidence-based clinical practice guidelines[J]. Chest, 2013, 143(5): 278-313.
2	Handy JR, Asaph JW, Douville EC, et al.Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy[J]. Eur J Cardiothorac Surg，2009，37(2): 451-455.
3	Matot I, Dery E, Bulgov Y, et al. Fluid management during video-assisted thoracoscopic surgery for lung resection: a randomized, controlled trial of effects on urinary output and postoperative renal function[J]. Journal of Thoracic & Cardiovascular Surgery, 2013, 146(2): 461-466.
4	Kim SJ, Lee YJ, Park JS, et al. Changes in pulmonary function in lung cancer patients after video-assisted thoracic surgery[J]. Annals of Thoracic Surgery, 2015, 99(1): 210-217.
5	Papiashvilli M, Sasson L, Azzam S, et al. Video-assisted thoracic surgery lobectomy versus lobectomy by thoracotomy for lung cancer: pilot study[J]. Innovations, 2013, 8(1): 6-11.
6	Murakawa T, Ichinose J, Hino H, et al. Long-term outcomes of open and video-assisted thoracoscopic lung lobectomy for the treatment of early stage non-small cell lung cancer are similar: a propensity-matched study[J]. World Journal of Surgery, 2015, 39(5): 1084-1091.
7	Flores RM. Video-assisted thoracic surgery (VATS) lobectomy: focus on technique[J]. World Journal of Surgery, 2010, 34(4): 616-620.
8	Veronesi G. Robotic thoracic surgery : technical considerations and learning curve for pulmonary resection[J]. Thoracic Surgery Clinics, 2014, 24(2): 135-141.
9	Veronesi G, Novellis P, Voulaz E, et al. Robot-assisted surgery for lung cancer: state of the art and perspectives[J]. Lung Cancer, 2016, 32(101): 28-34.
10	Shimada Y, Saji H, Kakihana M, et al. Retrospective analysis of nodal spread patterns according to tumor location in pathological n2 non-small cell lung cancer[J]. World Journal of Surgery, 2012, 36(12): 2865-2871.
11	Lee HS, Jang HJ. Thoracoscopic mediastinal lymph node dissection for lung cancer[J]. Semin Thorac Cardiovasc Surg, 2012，24(2): 131-141.
12	Ludwig MS, Goodman M, Miller DL, et al. Postoperative survival and the number of lymph nodes sampled during resection of node-negative non-small cell lung cancer[J]. Chest, 2005, 128(3): 1545-1550.
13	Kuzdzal J, Zielinski M. Complete resection in lung cancer surgery: proposed definition[J]．Lung Cancer，2006，101(1): 131-132.
14	Whitson BA, Andrade RS, Boettcher A, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage i non-small cell lung cancer[J]. Annals of Thoracic Surgery, 2007, 83(6): 1965-7190.
15	Kim AW. Lymph node drainage patterns and micrometastasis in lung cancer[J]. Seminars in Thoracic & Cardiovascular Surgery, 2009, 21(4): 298-308.
16	Tanaka F, Takenaka K, Oyanagi H, et al. Skip mediastinal nodal metastases in non-small cell lung cancer[J]. European Journal of Cardio-Thoracic Surgery, 2004, 25(6): 1114-1120.
17	Nwogu CE, Yendamuri S, Tan W, et al. Lung cancer lymph node micrometastasis detection using real-time polymerase chain reaction: correlation with vascular endothelial growth factor expression[J]. Journal of Thoracic Cardiovascular Surgery, 2013, 145(3): 702-708.
18	Kernstine KH, Mclaughlin KA, Menda Y, et al. Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer[J]. Annals of Thoracic Surgery, 2002, 73(2): 401-402.
19	Chanida V, Poonchavist C, Virote S, et al. The role of shp-1 promoter 2 hypermethylation detection of lymph node micrometastasis in resectable stage i non-small cell lung cancer as a prognostic marker of disease recurrence[J]. International Journal of Clinical Oncology, 2014, 19(4): 586-592.
20	Elizabeth B, Peter G. Is radical mediastinal dissection mandatory for curative resection of NSCLC [J]. European Journal of Cardio-Thoracic Surgery, 2007, 31(1): 142-143.
21	Lardinois D, Suter H, Hakki H, et al. Morbidity, survival, and site of recurrence after mediastinal lymph-node dissection versus systematic sampling after complete resection for non-small cell lung cancer[J]. Annals of Thoracic Surgery, 2005, 80(1): 268-275.

组别	例数	年龄(岁， ±s)	性别(例)		肿瘤直径(cm, ±s)
组别	例数	年龄(岁， ±s)	男性	女性	肿瘤直径(cm, ±s)
机器人组	80	59.74 ± 10.0	46	34	2.71 ± 1.11
胸腔镜组	122	59.79 ± 9.2	77	45	3.00 ± 1.25
t值/χ²值	?	0.035	0.64		1.732
P值	?	0.972	0.424		0.085
组别	例数	病理类型(例)				TNM分期(例)
组别	例数	鳞癌	腺癌	腺鳞癌	其他	ⅠA	ⅠB	ⅡA	ⅡB	ⅢA
机器人组	80	20	58	1	1	44	7	5	10	14
胸腔镜组	122	36	71	5	8	55	9	5	16	37
t值/χ²值	?	6.242				4.70
P值	?	0.098				0.323

组别	例数	年龄(岁， ±s)	性别(例)		肿瘤直径(cm, ±s)
组别	例数	年龄(岁， ±s)	男性	女性	肿瘤直径(cm, ±s)
机器人组	80	59.74 ± 10.0	46	34	2.71 ± 1.11
胸腔镜组	122	59.79 ± 9.2	77	45	3.00 ± 1.25
t值/χ²值	?	0.035	0.64		1.732
P值	?	0.972	0.424		0.085
组别	例数	病理类型(例)				TNM分期(例)
组别	例数	鳞癌	腺癌	腺鳞癌	其他	ⅠA	ⅠB	ⅡA	ⅡB	ⅢA
机器人组	80	20	58	1	1	44	7	5	10	14
胸腔镜组	122	36	71	5	8	55	9	5	16	37
t值/χ²值	?	6.242				4.70
P值	?	0.098				0.323

组别	例数	淋巴结清扫组数(组， ±s)	淋巴结清扫数(枚， ±s)	淋巴结清扫总数(枚)	阳性淋巴结数量[枚(%)]
机器人组	80	4.89 ± 1.57	16.93 ± 8.00	1 354	145(10.7)
胸腔镜组	122	4.25 ± 1.23	13.98 ± 8.67	1 706	154(9.0)
t值/ χ²值	?	－2.943	－2.471	－	2.42
P值	?	0.004	0.014	－	0.120

组别	例数	淋巴结清扫组数(组， ±s)	淋巴结清扫数(枚， ±s)	淋巴结清扫总数(枚)	阳性淋巴结数量[枚(%)]
机器人组	80	4.89 ± 1.57	16.93 ± 8.00	1 354	145(10.7)
胸腔镜组	122	4.25 ± 1.23	13.98 ± 8.67	1 706	154(9.0)
t值/ χ²值	?	－2.943	－2.471	－	2.42
P值	?	0.004	0.014	－	0.120

组别	例数	Ⅰ期淋巴结清扫数	Ⅱ期淋巴结清扫数	ⅢA期淋巴结清扫数
机器人组	80	16.59 ± 8.57	16.53 ± 7.33	18.57 ± 6.70
胸腔镜组	122	11.86 ± 6.61	20.24 ± 10.87	14.11 ± 8.94
t值	?	－3.245	1.221	－1.927
P值	?	0.002	0.230	0.063

Please choose a citation manager

Content to export