| 摘要: |
| ［摘要］ 目的 比较经剑突下入路与经侧胸入路达芬奇机器人辅助胸腔镜手术（RATS）治疗前纵隔肿瘤的疗效。方法 回顾性分析2021年7月至2025年6月于广西壮族自治区人民医院接受RATS治疗的50例前纵隔肿瘤患者的临床资料。根据手术入路方式将患者分为剑突下入路组（n=30）和侧胸入路组（n=20），比较两组基线资料、围手术期指标、术后住院时间、住院总费用及术后并发症发生率。结果 所有患者均顺利完成手术。与剑突下入路组相比，侧胸入路组手术时间和术后引流管留置时间显著缩短（P<0.05），术中出血量显著减少（P<0.05）。两组术后48 h引流量、术后第1天视觉模拟量表（VAS）评分、术后第1天C反应蛋白（CRP）水平及术后第1天白细胞计数比较差异无统计学意义（P>0.05）。侧胸入路组术后住院时间显著短于剑突下入路组（P<0.05），但两组住院总费用比较差异无统计学意义（P>0.05）。两组并发症发生率比较差异无统计学意义（P>0.05）。结论 RATS经侧胸入路较经剑突下入路治疗前纵隔肿瘤，可缩短手术时间、术后引流管留置时间和术后住院时间，减少术中出血量，手术效果更具优势。 |
| 关键词: 机器人辅助胸腔镜手术 剑突下入路 侧胸入路 前纵隔肿瘤 |
| DOI：10.3969/j.issn.1674-3806.2025.10.04 |
| 分类号: |
| 基金项目:广西医疗卫生适宜技术开发与推广应用项目（编号：S2024013） |
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| Comparison of efficacy of da Vinci robot-assisted thoracoscopic surgery in treatment of anterior mediastinal tumors via subxiphoid approach and lateral thoracic intercostal approach |
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PEI Shimin1, ZHOU Yifan2, SHEN Bin2, HUANG Jianwei2, ZHANG Chen2
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1.Graduate School, Youjiang Medical University for Nationalities, Baise 533000, China; 2.Department of Thoracic Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To compare the efficacy of da Vinci robot-assisted thoracoscopic surgery(RATS) in treatment of anterior mediastinal tumors via subxiphoid approach and lateral thoracic intercostal approach. Methods A retrospective analysis was conducted on the clinical data of 50 patients who underwent RATS for anterior mediastinal tumor resection in the People′s Hospital of Guangxi Zhuang Autonomous Region from July 2021 to June 2025. According to the surgical approaches, the patients were divided into subxiphoid approach group(n=30) and lateral thoracic intercostal approach group(n=20). The baseline data, perioperative indicators, postoperative hospital stay, total hospitalization cost and the incidence of postoperative complications were compared between the two groups. Results All the patients′ operations were successfully completed. Compared with the subxiphoid approach group, the lateral thoracic intercostal approach group had significantly shorter durations of operation and postoperative drainage tube retention(P<0.05), and significantly less intraoperative blood loss(P<0.05). However, there were no statistically significant differences in postoperative 48-hour drainage volume, and in Visual Analogue Scale(VAS) scores, C-reactive protein(CRP) level and white blood cell count on the first day after operation between the two groups(P>0.05). The postoperative hospital stay of the lateral thoracic intercostal approach group was significantly shorter than that of the subxiphoid approach group(P<0.05), but there was no statistically significant difference in the total hospitalization cost between the two groups(P>0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05). Conclusion Compared with RATS via the subxiphoid approach, RATS via the lateral thoracic intercostal approach can shorten durations of operation and postoperative drainage tube retention, and postoperative hospital stay, and reduce intraoperative blood loss in treatment of anterior mediastinal tumors, and the surgical effect of RATS via the lateral thoracic intercostal approach is more advantageous. |
| Key words: Robot-assisted thoracoscopic surgery Subxiphoid approach Lateral thoracic intercostal approach Anterior mediastinal tumors |
