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目的探讨达芬奇机器人手术系统(da Vinci Surgical System)在行纵隔肿瘤切除术后不放置引流管的可行性及优势。方法 2011年3月至2015年3月我科共有39例患者行机器人纵隔肿瘤切除术后未放置引流管,作为未放置引流管组,其中男24例、女15例,年龄47.28(18~73)岁。选取同期行机器人纵隔囊肿切除术50例术后放置胸腔引流管为放置引流管组,其中男25例、女25例,年龄49.24(22~82)岁。比较两组临床效果。结果未放置引流管组手术时间[(61.97±16.41)min vs.(79.90±33.19)min,P=0.003],重症监护时间[(1.23±0.48)d vs.(2.16±0.82)d,P=0.000],术后住院时间[(3.77±1.16)d vs.(5.62±2.22)d,P=0.000]和术后视觉模拟评分(visual analogue scale,VAS 3.05±1.76 vs.4.54±1.83,P=0.000)均优于放置引流管组。所有患者应用达芬奇机器人手术系完成手术,无中转开胸。术后患者均顺利出院,无并发症发生。结论采用达芬奇机器人手术系统行纵隔肿瘤切除不放置引流管安全可行,利于患者快速康复,缩短住院时间。
Objective To investigate the feasibility and advantages of the da Vinci Surgical System without placing a drainage tube after mediastinal tumor resection. Methods From March 2011 to March 2015, a total of 39 patients in our department underwent robotic mediastinal tumor resection without drainage tube. There were 24 males and 15 females, aged 47.28 (18-73) )year old. Select the same period robotic mediastinal cyst resection in 50 cases were placed after the drainage tube for the placement of drainage tube group, including 25 males and 25 females, aged 49.24 (22 to 82) years of age. The clinical effects of two groups were compared. Results There was no significant difference between the two groups (P> 0.05). The duration of intensive care ([1.61 ± 0.48] d vs. (2.16 ± 0.82) d, P = (P <0.05), postoperative hospital stay (3.77 ± 1.16 vs. d = 5.62 ± 2.22, P = 0.000) and postoperative visual analogue scale (VAS 3.05 ± 1.76 vs.4.54 ± 1.83, P = 0.000) were better than placing drainage tube group. All patients with Da Vinci robotic surgery department to complete the operation, no transfer thoracotomy. Patients were successfully discharged, no complications. Conclusions It is safe and feasible to use the Da Vinci robotic surgical system to resect mediastinal tumor without drainage tube, which will benefit the patients recover quickly and shorten the hospitalization time.