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, 刘会平, 杨运有.电视胸腔镜肺癌根治术5年临床疗效.中国胸心血管外科临床杂志, 2002, 9(1):29-31.
2.	曾智理, 李单青, 李力, 等.电视胸腔镜辅助小切口肺叶切除治疗周围性型肺癌.中国微创外科杂志, 2009, 9:694-695.
3.	王述民, 曲家骐, 侯维平, 等.完全电视胸腔镜和胸腔镜辅助小切口型肺叶切除术481例.中华胸心血管外科杂志, 2010, 26(9):310-311.
4.	刘伦旭.胸腔镜肺癌切除:多样化的手术切口和流程.医学与哲学(临床决策论坛版), 2011, 32(9):11-13.
5.	陈海泉.胸腔镜下非小细胞肺癌的外科治疗:一项原则和两个基本点.医学与哲学(临床决策论坛版), 2011, 32(9):9-10, 33.
6.	李文涛, 姜格宁, 高文, 等.序贯式全胸腔镜肺叶切除术的临床应用.中华外科杂志, 2011, 49(5):468-469.
7.	梅建东, 蒲强, 刘伦旭, 等.全胸腔镜支气管袖式成形肺癌切除的流程设计与优化.四川大学学报(医学版), 2013, 44(1):114-118.
8.	马林, 刘伦旭, 蒲强, 等.电视胸腔镜手术中缝线定位法在肺部非浅表小结节活检和切除术中的应用.中国胸心血管外科临床杂志, 2013, 20(6):735-737.
9.	朱彦杰, 杨永珠, 李文涛.全胸腔镜下飞短切除书的临床应用.当代医学, 2013, 19(32):1-4.
10.	罗宜人, 王耀鹏, 王明钊, 等.临床I期非小细胞肺癌电视胸腔镜肺叶切除术中淋巴结清扫的对照研究.中国微创外科杂志, 2011, 11(1):73-75.
11.	陈胜, 胡卫建, 谷电雷.全胸腔镜肺叶切除治疗早期肺癌22例临床报道.临床肺科杂志, 2012, 17(3):499-500.
12.	陶显东, 潘铁文, 吴彬, 等.电视胸腔镜手术在非小细胞肺癌治疗中的优势.中华肺部疾病杂志(电子版), 2011, 4(3):33-36.
13.	卜梁, 李运, 杨帆, 等.直径大于5 cm非小细胞肺癌患者行全胸腔镜肺叶切除手术与开胸手术疗效的对比研究.北京大学学报(医学版), 2011, 43(6):866-872.
14.	李凤卫, 姜冠潮, 李运, 等.全胸腔镜与开胸肺叶切除治疗cN0-pN2非小细胞肺癌效果初步比较.北京大学学报(医学版), 2011, 43(6):861-865.
15.	李泽树, 杜波, 杨建国.全胸腔镜下手术治疗26例早期肺癌的体会.实用癌症杂志, 2010, 25(6):607-608, 615.
16.	王如文, 邓波, 谭群友.电视胸腔镜手术在肺癌治疗中有待解决的问题.中华肺部疾病杂志(电子版), 2011, 4(3):9-11.
17.	郭刚, 侯文俊, 李高峰, 等.完全胸腔镜下肺叶切除术治疗非小细胞肺癌54例临床分析.昆明医学院学报, 2011, 32(9):24-27.
18.	胡定中, 林凌, 沈宇舟, 等.全胸腔镜肺叶切除术在临床早期肺癌的应用价值.上海医学, 2010, 33(9):841-844.
19.	何建行, 杨运有, 陈满荫, 等.胸腔镜肺叶切除术.中华外科杂志, 1996, 34:73-75.
20.	邹卫, 许栋生, 苏宜江.左肺上叶切除的血管处理.中华胸心血管外科杂志, 2006, 22(1):57.
21.	刘奎, 李力元, 王茂龙, 等.胸腔镜肺叶切除术难点体会.临床肺科杂志, 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.	刘伦旭, 车国卫, 蒲强, 等.单向式全胸腔镜肺叶切除术.中华胸心血管外科杂志, 2008, 24(3):156-158.
25.	许世广, 童向东, 刘博, 等.机器人辅助胸腔镜下肺叶切除术16例报告.中国微创外科杂志, 2013, 13(9):806-809.
26.	王述民, 许世广, 童向东, 等.机器人肺叶切除术治疗非小细胞肺癌.中国胸心血管外科临床杂志, 2013, 20(3):308-311.

1. 何建行, 刘会平, 杨运有.电视胸腔镜肺癌根治术5年临床疗效.中国胸心血管外科临床杂志, 2002, 9(1):29-31.
2. 曾智理, 李单青, 李力, 等.电视胸腔镜辅助小切口肺叶切除治疗周围性型肺癌.中国微创外科杂志, 2009, 9:694-695.
3. 王述民, 曲家骐, 侯维平, 等.完全电视胸腔镜和胸腔镜辅助小切口型肺叶切除术481例.中华胸心血管外科杂志, 2010, 26(9):310-311.
4. 刘伦旭.胸腔镜肺癌切除:多样化的手术切口和流程.医学与哲学(临床决策论坛版), 2011, 32(9):11-13.
5. 陈海泉.胸腔镜下非小细胞肺癌的外科治疗:一项原则和两个基本点.医学与哲学(临床决策论坛版), 2011, 32(9):9-10, 33.
6. 李文涛, 姜格宁, 高文, 等.序贯式全胸腔镜肺叶切除术的临床应用.中华外科杂志, 2011, 49(5):468-469.
7. 梅建东, 蒲强, 刘伦旭, 等.全胸腔镜支气管袖式成形肺癌切除的流程设计与优化.四川大学学报(医学版), 2013, 44(1):114-118.
8. 马林, 刘伦旭, 蒲强, 等.电视胸腔镜手术中缝线定位法在肺部非浅表小结节活检和切除术中的应用.中国胸心血管外科临床杂志, 2013, 20(6):735-737.
9. 朱彦杰, 杨永珠, 李文涛.全胸腔镜下飞短切除书的临床应用.当代医学, 2013, 19(32):1-4.
10. 罗宜人, 王耀鹏, 王明钊, 等.临床I期非小细胞肺癌电视胸腔镜肺叶切除术中淋巴结清扫的对照研究.中国微创外科杂志, 2011, 11(1):73-75.
11. 陈胜, 胡卫建, 谷电雷.全胸腔镜肺叶切除治疗早期肺癌22例临床报道.临床肺科杂志, 2012, 17(3):499-500.
12. 陶显东, 潘铁文, 吴彬, 等.电视胸腔镜手术在非小细胞肺癌治疗中的优势.中华肺部疾病杂志(电子版), 2011, 4(3):33-36.
13. 卜梁, 李运, 杨帆, 等.直径大于5 cm非小细胞肺癌患者行全胸腔镜肺叶切除手术与开胸手术疗效的对比研究.北京大学学报(医学版), 2011, 43(6):866-872.
14. 李凤卫, 姜冠潮, 李运, 等.全胸腔镜与开胸肺叶切除治疗cN0-pN2非小细胞肺癌效果初步比较.北京大学学报(医学版), 2011, 43(6):861-865.
15. 李泽树, 杜波, 杨建国.全胸腔镜下手术治疗26例早期肺癌的体会.实用癌症杂志, 2010, 25(6):607-608, 615.
16. 王如文, 邓波, 谭群友.电视胸腔镜手术在肺癌治疗中有待解决的问题.中华肺部疾病杂志(电子版), 2011, 4(3):9-11.
17. 郭刚, 侯文俊, 李高峰, 等.完全胸腔镜下肺叶切除术治疗非小细胞肺癌54例临床分析.昆明医学院学报, 2011, 32(9):24-27.
18. 胡定中, 林凌, 沈宇舟, 等.全胸腔镜肺叶切除术在临床早期肺癌的应用价值.上海医学, 2010, 33(9):841-844.
19. 何建行, 杨运有, 陈满荫, 等.胸腔镜肺叶切除术.中华外科杂志, 1996, 34:73-75.
20. 邹卫, 许栋生, 苏宜江.左肺上叶切除的血管处理.中华胸心血管外科杂志, 2006, 22(1):57.
21. 刘奎, 李力元, 王茂龙, 等.胸腔镜肺叶切除术难点体会.临床肺科杂志, 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. 刘伦旭, 车国卫, 蒲强, 等.单向式全胸腔镜肺叶切除术.中华胸心血管外科杂志, 2008, 24(3):156-158.
25. 许世广, 童向东, 刘博, 等.机器人辅助胸腔镜下肺叶切除术16例报告.中国微创外科杂志, 2013, 13(9):806-809.
26. 王述民, 许世广, 童向东, 等.机器人肺叶切除术治疗非小细胞肺癌.中国胸心血管外科临床杂志, 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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