Da Vinci robot system in the surgical treatment of mediastinal lesions: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

BAI Qizhou ¹ , YU Jun ¹ ,  GOU Yunjiu ¹ , HE Shengliang ¹ , WANG Chengfeng ¹ , WANG Shumin ²

1. Department of Thoracic Surgery 1, Gansu Provincial Hospital, Lanhzou, 730000, P.R. China;
2. Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang, 110016, P.R.China;

Corresponding?author：

GOU Yunjiu, Email: gouyunjiu@163.com

Keywords：

Mediastinal lesions; da Vinci robot system; video-assisted thoracoscopic surgery; postoperative recovery

DOI：

10.7507/1007-4848.201711043

Video：

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Objective To summarize the clinical data about mediastinal lesions, then to analyze the treatment effect of da Vinci robot system in the surgical treatment of mediastinal lesions. Methods We retrospectively analyzed the clinical data of 49 patients with mediastinal lesions in our hospital between January 2016 and October 2017. These patients were divided into two groups including a da Vinci robot group and a video-assisted thoracoscopic surgery (VATS) group according to the selection of the treatments. There were 25 patients with 14 males and 11 females at age of 56.5±17.9 years in the da Vinci group and 24 patient with 15 males and 11 females at age of 53.0±17.8 years in the VATS group. Results There was no statistical difference in surgery time between the two groups (t=–0.365, P=0.681). Less intraoperative blood loss (t=–2.569, P<0.001), less postoperative drainage amount within three days after surgery (t=–6.325, P=0.045), shorter period of bearing drainage tubes after surgery (t=–1.687, P=0.024), shorter hospital stays (t=–3.689, P=0.021), lower visual analogue scale (VAS) scores of postoperative 48 hours (t=–7.214, P=0.014) with a statistical difference in the da Vinci robot group compared with the VATS group. Conclusion The da Vinci robot system is safe and efficient in the treatment of mediastinal lesions compared with video-assisted thoracoscopic approach.

Citation： BAI Qizhou, YU Jun, GOU Yunjiu, HE Shengliang, WANG Chengfeng, WANG Shumin. Da Vinci robot system in the surgical treatment of mediastinal lesions: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(5): 382-386. doi: 10.7507/1007-4848.201711043 Copy

1.	Buentzel J, Straube C, Heinz J, et al. Thymectomy via open surgery or robotic video assisted thoracic surgery: Can a recommendation already be made?. Medicine (Baltimore), 2017, 96(24): e7161.
2.	Friedant AJ, Handorf EA, Su S, et al. Minimally invasive versus open thymectomy for thymic malignancies: systematic review and meta-analysis. J Thorac Oncol, 2016, 11(1): 30-38.
3.	楊勝利, 茹婷巧, 楊劼, 等. 單操作孔全電視胸腔鏡手術在縱隔腫物切除中的應用. 華中科技大學學報(醫學版), 2015, 44(3): 330-333.
4.	陳世雄, 陳勝家, 許家君, 等. 單操作孔電視胸腔鏡手術治療前縱隔腫瘤. 中國胸心血管外科臨床雜志, 2016, 23(1): 634-635.
5.	Bodner J, Wykypiel H, Wetscher G, et al. First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg, 2004, 25(5): 844-851.
6.	Bodner J, Wykypiel H, Greiner A, et al. Early experience with robot-assisted surgery for mediastinal masses. Ann Thorac Surg, 2004, 78(1): 259-265.
7.	Augustin F, Schmid T, Bodner J. The robotic approach for mediastinal lesions. Int J Med Robot, 2006, 2(3): 262-270.
8.	Marulli G, Schiavon M, Perissinotto E, et al. Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis. J Thorac Cardiovasc Surg, 2013, 145(3): 730-736.
9.	Marulli G, Comacchio G M, Rea F. Robotic thymectomy. J Vis Surg, 2017, 3(1): 68.
10.	Marulli G, Maessen J, Melfi F, et al. Multi-institutional European experience of robotic thymectomy for thymoma. Ann Cardiothorac Surg, 2016, 5(1): 18-25.
11.	Yoshino I, Hashizume M, Shimada M, et al. Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system. J Thorac Cardiovasc Surg, 2001, 122(4): 783-785.
12.	Hartwich J, Tyagi S, Margaron F, et al. Robot-assisted thoracoscopic thymectomy for treating myasthenia gravis in children. J Laparoendosc Adv Surg Tech A, 2012, 22(9): 925-929.
13.	丁仁泉, 童向東, 許世廣, 等. 達芬奇機器人手術系統與電視電視胸腔鏡在胸內縱隔疾病手術治療中的對比研究. 中國肺癌雜志, 2014, 7(1): 557-562.
14.	Ruckert J C, Swierzy M, Ismail M. Comparison of robotic and nonrobotic thoracoscopic thymectomy: a cohort study. J Thorac Cardiovasc Surg, 2011, 141(3): 673-677.
15.	Castle S L, Kernstine K H. Robotic-assisted thymectomy. Semin Thorac Cardiovasc Surg, 2008, 20(4): 326-331.
16.	Nakamura H, Suda T, Ikeda N, et al. Initial results of robot-assisted thoracoscopic surgery in Japan. Gen Thorac Cardiovasc Surg, 2014, 62(12): 720-725.
17.	Jun Y, Hao L, Demin L, et al. Da Vinci robot-assisted system for thymectomy: experience of 55 patients in China. Int J Med Robot, 2014, 10(3): 294-299.
18.	劉博, 汪明敏, 許世廣, 等. 達芬奇機器人縱隔腫瘤切除術的學習曲線. 中國胸心血管外科臨床雜志, 2017, 24(1): 127-131.
19.	Rueckert J, Swierzy M, Badakhshi H, et al. Robotic-assisted thymectomy: surgical procedure and results. Thorac Cardiovasc Surg, 2015, 63(3): 194-200.
20.	Ye B, Tantai J C, Li W, et al. Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery in the surgical treatment of Masaoka stage I thymoma. World J Surg Oncol, 2013, 11(1):157.
21.	Della Marina A, Kolbel H, Mullers M, et al. Outcome after robotic-assisted thymectomy in children and adolescents with acetylcholine receptor antibody-positive juvenile myasthenia gravis. Neuropediatrics, 2017, 48(4): 315-322.
22.	Straughan DM, Fontaine JP, Toloza EM. Robotic-assisted videothoracoscopic mediastinal surgery. Cancer Control, 2015, 22(3): 326-330.

1. Buentzel J, Straube C, Heinz J, et al. Thymectomy via open surgery or robotic video assisted thoracic surgery: Can a recommendation already be made?. Medicine (Baltimore), 2017, 96(24): e7161.
2. Friedant AJ, Handorf EA, Su S, et al. Minimally invasive versus open thymectomy for thymic malignancies: systematic review and meta-analysis. J Thorac Oncol, 2016, 11(1): 30-38.
3. 楊勝利, 茹婷巧, 楊劼, 等. 單操作孔全電視胸腔鏡手術在縱隔腫物切除中的應用. 華中科技大學學報(醫學版), 2015, 44(3): 330-333.
4. 陳世雄, 陳勝家, 許家君, 等. 單操作孔電視胸腔鏡手術治療前縱隔腫瘤. 中國胸心血管外科臨床雜志, 2016, 23(1): 634-635.
5. Bodner J, Wykypiel H, Wetscher G, et al. First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg, 2004, 25(5): 844-851.
6. Bodner J, Wykypiel H, Greiner A, et al. Early experience with robot-assisted surgery for mediastinal masses. Ann Thorac Surg, 2004, 78(1): 259-265.
7. Augustin F, Schmid T, Bodner J. The robotic approach for mediastinal lesions. Int J Med Robot, 2006, 2(3): 262-270.
8. Marulli G, Schiavon M, Perissinotto E, et al. Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis. J Thorac Cardiovasc Surg, 2013, 145(3): 730-736.
9. Marulli G, Comacchio G M, Rea F. Robotic thymectomy. J Vis Surg, 2017, 3(1): 68.
10. Marulli G, Maessen J, Melfi F, et al. Multi-institutional European experience of robotic thymectomy for thymoma. Ann Cardiothorac Surg, 2016, 5(1): 18-25.
11. Yoshino I, Hashizume M, Shimada M, et al. Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system. J Thorac Cardiovasc Surg, 2001, 122(4): 783-785.
12. Hartwich J, Tyagi S, Margaron F, et al. Robot-assisted thoracoscopic thymectomy for treating myasthenia gravis in children. J Laparoendosc Adv Surg Tech A, 2012, 22(9): 925-929.
13. 丁仁泉, 童向東, 許世廣, 等. 達芬奇機器人手術系統與電視電視胸腔鏡在胸內縱隔疾病手術治療中的對比研究. 中國肺癌雜志, 2014, 7(1): 557-562.
14. Ruckert J C, Swierzy M, Ismail M. Comparison of robotic and nonrobotic thoracoscopic thymectomy: a cohort study. J Thorac Cardiovasc Surg, 2011, 141(3): 673-677.
15. Castle S L, Kernstine K H. Robotic-assisted thymectomy. Semin Thorac Cardiovasc Surg, 2008, 20(4): 326-331.
16. Nakamura H, Suda T, Ikeda N, et al. Initial results of robot-assisted thoracoscopic surgery in Japan. Gen Thorac Cardiovasc Surg, 2014, 62(12): 720-725.
17. Jun Y, Hao L, Demin L, et al. Da Vinci robot-assisted system for thymectomy: experience of 55 patients in China. Int J Med Robot, 2014, 10(3): 294-299.
18. 劉博, 汪明敏, 許世廣, 等. 達芬奇機器人縱隔腫瘤切除術的學習曲線. 中國胸心血管外科臨床雜志, 2017, 24(1): 127-131.
19. Rueckert J, Swierzy M, Badakhshi H, et al. Robotic-assisted thymectomy: surgical procedure and results. Thorac Cardiovasc Surg, 2015, 63(3): 194-200.
20. Ye B, Tantai J C, Li W, et al. Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery in the surgical treatment of Masaoka stage I thymoma. World J Surg Oncol, 2013, 11(1):157.
21. Della Marina A, Kolbel H, Mullers M, et al. Outcome after robotic-assisted thymectomy in children and adolescents with acetylcholine receptor antibody-positive juvenile myasthenia gravis. Neuropediatrics, 2017, 48(4): 315-322.
22. Straughan DM, Fontaine JP, Toloza EM. Robotic-assisted videothoracoscopic mediastinal surgery. Cancer Control, 2015, 22(3): 326-330.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Da Vinci robot system in the surgical treatment of mediastinal lesions: A case control study

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