Efficacy of multidisciplinary team combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer: A retrospective study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DING Renquan , CHENG Ming , XU Wei , WU Qiong , WANG Feifei , WANG Yue , HU Boxiao ,  WANG Shumin

1. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China;

Corresponding?author：

WANG Shumin, Email: sureman2003congo@163.com

Keywords：

Multidisciplinary team; non-small cell lung cancer; Da Vinci robot; postoperative complications; enhanced recovery after surgery

DOI：

10.7507/1007-4848.202206074

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Objective To investigate the clinical efficacy of multidisciplinary team (MDT) model combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer (NSCLC). Methods From July 2020 to December 2021, the patients with NSCLC who received Da Vinci robot-assisted thoracic surgery in the Department of Thoracic Surgery, General Hospital of Northern Theater Command were collected. According to whether MDT were performed before hospitalization, the patients were divided into an MDT group and a common group. The recovery and clinical efficacy were compared between the two groups. Results A total of 187 patients were enrolled, including 81 males and 106 females, aged 63 (56, 67) years. There were 85 patients in the MDT group, and 102 patients in the common group. Compared with the common group, the MDT group had lower incidence of postoperative complications (9.4% vs. 29.4%, P=0.017), shorter intraoperative operation time [55 (45, 61) min vs. 79 (65, 90) min, P<0.001], and less intraoperative blood loss [25 (20, 30) mL vs. 30 (20, 50) mL, P=0.029] in the same operation mode. In addition, the drainage volume on the second postoperative day [270 (200, 350) mL vs. 215 (190, 300) mL, P=0.004], the number of dissected lymph nodes groups [6 (5, 6) groups vs. 5 (3, 6) groups, P=0.004] and the number of dissected lymph nodes [16 (13, 21) vs. 13 (9, 20), P=0.005] in the MDT group were significantly better than those in the common group. The differences in the postoperative intubation time and postoperative hospital stay between the two groups were not statistically significant (P>0.05). Conclusion MDT combined with Da Vinci robot-assisted thoracic surgery can further reduce the risk of surgery, improve the clinical treatment effect, reduce the incidence of postoperative complications, and accelerate the rehabilitation of patients.

Citation： DING Renquan, CHENG Ming, XU Wei, WU Qiong, WANG Feifei, WANG Yue, HU Boxiao, WANG Shumin. Efficacy of multidisciplinary team combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer: A retrospective study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(3): 392-396. doi: 10.7507/1007-4848.202206074 Copy

1.	鐘文昭, 中國胸部腫瘤研究協作組, 中國抗癌協會肺癌專業委員會, 等. 肺癌多學科團隊診療中國專家共識. 中華腫瘤雜志, 2020, 42(10): 817-828.
2.	傅睿, 吳一龍, 鐘文昭. 2020版肺癌多學科團隊診療中國專家共識解讀. 中國腫瘤臨床, 2022, 49(4): 163-167.
3.	Lamprell K, Arnolda G, Delaney GP, et al. The challenge of putting principles into practice: Resource tensions and real-world constraints in multidisciplinary oncology team meetings. Asia Pac J Clin Oncol, 2019, 15(4): 199-207.
4.	Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence and mortality in China, 2016. JNCC, 2022, 2(1): 1-9.
5.	劉寶東, 支修益. 肺結節、肺癌的一站式管理—從多學科團隊到多學科醫生. 中國胸心血管外科臨床雜志, 2022, 29(3): 288-293.
6.	Gaudioso C, Sykes A, Whalen PE, et al. Impact of a thoracic multidisciplinary conference on lung cancer outcomes. Ann Thorac Surg, 2022, 113(2): 392-398.
7.	Nemesure B, Albano D, Bilfinger T. Lung cancer recurrence and mortality outcomes over a 10-year period using a multidisciplinary team approach. Cancer Epidemiol, 2020, 68: 101804.
8.	Liu H, Song Y. MDT is still important in the treatment of early stage lung cancer. J Thorac Dis, 2018, 10(Suppl 33): S3984-S3985.
9.	Winters DA, Soukup T, Sevdalis N, et al. The cancer multidisciplinary team meeting: In need of change? History, challenges and future perspectives. BJU Int, 2021, 128(3): 271-279.
10.	Stone E, Rankin N, Kerr S, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
11.	徐洪麗, 魏少忠. 多學科診療模式在湖北省腫瘤醫院的實踐. 腫瘤防治研究, 2018, 45(7): 437-440.
12.	Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Intern Med J, 2009, 39(12): 838-841.
13.	溫倩南, 李悅嫻, 孫德峰. 加速康復外科理念下麻醉管理的研究進展. 中國醫師雜志, 2022, 24(6): 814-818, 822.
14.	Deng YH, Dong LL, Zhang YJ, et al. Enriched environment boosts the post-stroke recovery of neurological function by promoting autophagy. Neural Regen Res, 2021, 16(5): 813-819.
15.	Laganà AS, Garzon S, Casarin J, et al. Acupoint massage to manage postoperative ileus in gynecologic laparoscopy: A new potential player in the enhanced recovery after surgery (ERAS) pathways? J Invest Surg, 2021, 34(1): 96-98.
16.	成名, 許世廣, 徐惟, 等. 機器人輔助與電視輔助胸腔鏡手術治療非小細胞肺癌近遠期生存差異的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2022, 29(9): 1133-1139.
17.	蘭軻, 周健, 郭海華, 等. 基于TM&M分級系統肺癌胸腔鏡肺主要手術并發癥列線圖預測模型的建立和驗證. 中國肺癌雜志, 2021, 24(12): 838-846.
18.	孫琛, 孫曉杰, 王家林, 等. 腫瘤多學科協作診療模式的發展現狀及評價研究進展. 中國醫院管理, 2022, 42(8): 53-56.
19.	中國抗癌協會肺癌專業委員會, 中華醫學會腫瘤學分會肺癌學組. Ⅲ期非小細胞肺癌多學科診療專家共識 (2019版). 中華腫瘤雜志, 2019, 41(12): 881-890.
20.	中國醫師協會腫瘤醫師分會, 中國醫療保健國際交流促進會腫瘤內科分會. 中國Ⅳ期原發性肺癌多學科團隊診療實施指南. 中華腫瘤雜志, 2022, 44(7): 667-672.

1. 鐘文昭, 中國胸部腫瘤研究協作組, 中國抗癌協會肺癌專業委員會, 等. 肺癌多學科團隊診療中國專家共識. 中華腫瘤雜志, 2020, 42(10): 817-828.
2. 傅睿, 吳一龍, 鐘文昭. 2020版肺癌多學科團隊診療中國專家共識解讀. 中國腫瘤臨床, 2022, 49(4): 163-167.
3. Lamprell K, Arnolda G, Delaney GP, et al. The challenge of putting principles into practice: Resource tensions and real-world constraints in multidisciplinary oncology team meetings. Asia Pac J Clin Oncol, 2019, 15(4): 199-207.
4. Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence and mortality in China, 2016. JNCC, 2022, 2(1): 1-9.
5. 劉寶東, 支修益. 肺結節、肺癌的一站式管理—從多學科團隊到多學科醫生. 中國胸心血管外科臨床雜志, 2022, 29(3): 288-293.
6. Gaudioso C, Sykes A, Whalen PE, et al. Impact of a thoracic multidisciplinary conference on lung cancer outcomes. Ann Thorac Surg, 2022, 113(2): 392-398.
7. Nemesure B, Albano D, Bilfinger T. Lung cancer recurrence and mortality outcomes over a 10-year period using a multidisciplinary team approach. Cancer Epidemiol, 2020, 68: 101804.
8. Liu H, Song Y. MDT is still important in the treatment of early stage lung cancer. J Thorac Dis, 2018, 10(Suppl 33): S3984-S3985.
9. Winters DA, Soukup T, Sevdalis N, et al. The cancer multidisciplinary team meeting: In need of change? History, challenges and future perspectives. BJU Int, 2021, 128(3): 271-279.
10. Stone E, Rankin N, Kerr S, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
11. 徐洪麗, 魏少忠. 多學科診療模式在湖北省腫瘤醫院的實踐. 腫瘤防治研究, 2018, 45(7): 437-440.
12. Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Intern Med J, 2009, 39(12): 838-841.
13. 溫倩南, 李悅嫻, 孫德峰. 加速康復外科理念下麻醉管理的研究進展. 中國醫師雜志, 2022, 24(6): 814-818, 822.
14. Deng YH, Dong LL, Zhang YJ, et al. Enriched environment boosts the post-stroke recovery of neurological function by promoting autophagy. Neural Regen Res, 2021, 16(5): 813-819.
15. Laganà AS, Garzon S, Casarin J, et al. Acupoint massage to manage postoperative ileus in gynecologic laparoscopy: A new potential player in the enhanced recovery after surgery (ERAS) pathways? J Invest Surg, 2021, 34(1): 96-98.
16. 成名, 許世廣, 徐惟, 等. 機器人輔助與電視輔助胸腔鏡手術治療非小細胞肺癌近遠期生存差異的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2022, 29(9): 1133-1139.
17. 蘭軻, 周健, 郭海華, 等. 基于TM&M分級系統肺癌胸腔鏡肺主要手術并發癥列線圖預測模型的建立和驗證. 中國肺癌雜志, 2021, 24(12): 838-846.
18. 孫琛, 孫曉杰, 王家林, 等. 腫瘤多學科協作診療模式的發展現狀及評價研究進展. 中國醫院管理, 2022, 42(8): 53-56.
19. 中國抗癌協會肺癌專業委員會, 中華醫學會腫瘤學分會肺癌學組. Ⅲ期非小細胞肺癌多學科診療專家共識 (2019版). 中華腫瘤雜志, 2019, 41(12): 881-890.
20. 中國醫師協會腫瘤醫師分會, 中國醫療保健國際交流促進會腫瘤內科分會. 中國Ⅳ期原發性肺癌多學科團隊診療實施指南. 中華腫瘤雜志, 2022, 44(7): 667-672.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of multidisciplinary team combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer: A retrospective study in a single center

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