[Survival Analysis of Stage I Non-small Cell Lung Cancer Patients Treated with Da Vinci Robot-assisted Thoracic Surgery].

: 【中文题目：I期非小细胞肺癌达芬奇机器人手术的
疗效分析】 【中文摘要：背景与目的 达芬奇机器人手术系统在胸外科的应用日益广泛，本研究旨在探讨经达芬奇机器人手术治疗I期非小细胞肺癌（non-small cell lung cancer, NSCLC）患者的疗效。方法 回顾2012年1月-2017年12月于我科行手术治疗的I期NSCLC患者347例，依据手术方式分为机器人（robot-assisted thoracic surgery, RATS）组134例及腔镜（video-assisted thoracic surgery, VATS）组213例。比较两组患者围术期一般指标（术中出血量、术后引流量、术后带管时间、术后住院时间、淋巴结清扫状况），分析患者生存状况（overall survival, OS）、无进展生存状况（disease free survival, DFS）及相关影响因子。结果 机器人组与腔镜组术中出血量［(49±39) mL vs (202±239) mL］、术后引流量［Day 1: (248±123) mL vs (350±213) mL; Day 2: (288±189) mL vs (338±189) mL］比较，机器人组均少于腔镜组（P 0.05）。机器人组与腔镜组的淋巴结清扫组数［（5±2）组 vs （4±2）组］及淋巴清扫数量［（18±9）枚 vs（11±8）枚]比较，机器人组均优于腔镜组（P 0.05）。无进展生存状况：机器人组与腔镜组比较［1年无进展生存率：93.7% vs 91.3%、3年无进展生存率：87.7% vs 68.4%、5年无进展生存率：87.7% vs 52.5%，平均无进展生存时间（month）：61 vs 50］，机器人组明显优于腔镜组（P 0.05]; corresponding there had a statistically significant difference of DFS between the two groups [1-year DFS: 93.7% vs 91.3%; 3-year DFS: 87.7% vs 68.4%; 5-year DFS: 87.7% vs 52.5%; disease free survival time (mean): 61 months vs 50 months, P<0.05]. The univariate analysis found that the amounts of the lymph nodes dissection was the prognostic factor for OS and tumor diameter, surgical approach, stations and amounts of the lymph nodes dissection were respectively the prognostic factors for DFS. However, multivariate analysis found that there was not independently factors for OS, but the tumor diameter and surgical approach were independently associated with DFS. CONCLUSIONS: There was no significant difference about OS between the two groups, but the RATS got better DFS. RATS got more number of the LN dissection and less blood lose.