达芬奇机器人与胸腔镜手术治疗对肺癌根治术患者近期疗效、术后营养水平和免疫功能的影响比较

目的 对比分析达芬奇机器人手术和胸腔镜手术对肺癌根治术患者近期疗效、术后营养状况和免疫功能的影响.方法 回顾性选取2019年12月至2020年11月在江苏省肿瘤医院接受肺癌根治术治疗的患者120例,根据患者所用手术方式的不同分为胸腔镜组和达芬奇组,各60例.胸腔镜组患者接受胸腔镜手术治疗,达芬奇组接受达芬奇机器人辅助手...

Comparison of the effects of Da Vinci robotic surgery and thoracoscopic surgery on the short-term curative effect,postoperative nutritional status and immune function of patients undergoing radical resection of lung cancer

Objective Comparative analysis of the effects of Da Vinci robotic surgery and thoracoscopic surgery on the short-term curative effect,postoperative nutritional status and immune function of patients undergoing radical resection of lung cancer.Methods A total of 120 patients who received radical mastectomy for lung cancer in Jiangsu Cancer Hospital from December 2019 to November 2020 were retrospectively selected.Patients were divided into thoracoscopy group and Da Vinci group according to different surgical methods,each group 60 cases.Patients in the thoracoscopy group received thoracoscopic surgery for treatment,the Da Vinci group received Da Vinci robot-assisted surgery.The operation time,intraoperative blood loss,postoperative drainage tube indwelling time,postoperative hospital stay time,and postoperative complications were compared between the two groups of patients.Three days after operation,human enzyme-linked immunosorbent assay kit(ELISA)was used to detect serum malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and total antioxidant capacity(T-AOC)and total superoxide dismutase(T-SOD)levels in patients;the level of prealbumin in serum of patients was detected by immunoturbidimetric method;serum albumin content was detected using corresponding kits;serum hemoglobin content was detected by automatic blood analyzer;peripheral blood T lymphocyte subtypes were detected by Analysis CytoFLEX flow cytometer.Results The operation time of the Da Vinci group was(192.32±53.21)min,which was significantly higher than that of the thoracoscopy group[(156.32±43.25)min],but the intraoperative blood loss,drainage tube indwelling time and hospital stay of the Da Vinci group were(175.32±80.12)mL,(3.38±5.44)d,(7.12±1.03)d,which were significantly lower than those of the thoracoscopy group[(202.32±79.61)mL,(5.67±2.32)d,(8.91±1.52)d],the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the thoracoscopy group and the Da Vinci group(P>0.05).The level of serum malondialdehyde in the Da Vinci group was(8.36±0.89)nmol/L,which was significantly lower than that in the thoracoscopy group[(12.85±1.62)nmol/L],while the levels of serum GSH-px,T-AOC,T-SOD,prealbumin,albumin and hemoglobin were(215.32±32.95)U/L,(12.58±2.32)U/mL,(93.56±7.99)U/mL,(221.38±42.35)g/L,(28.96±4.69)g/L,(84.35±7.72)g/L,which were significantly higher than those in the thoracoscopy group[(156.32±11.25)U/L,(8.36±1.05)U/mL,(74.62±8.32)U/mL,(191.32±28.33)g/L,(26.32±4.28)g/L,(76.25±8.02)g/L],the differences were statistically significant(P<0.05).The incidence of postoperative nutritional risk in the Da Vinci group was 58.33%,which was significantly lower than that in the thoracoscopy group(76.67%),and the difference was statistically significant(P<0.05).There was no significant difference between the two groups of patients in peripheral blood CD3+T lymphocytes and the control group after surgery(P>0.05),while the postoperative peripheral blood CD4+and CD4+/CD8+T lymphocyte subsets in the Da Vinci group were(36.38±4.45)%,1.35±0.32,which were significantly higher than those in the thoracoscopy group[(34.12±4.82)%,1.24±0.29],and the CD8+T lymphocyte subsets was(26.78±4.02)%,which was significantly lower than that in the thoracoscopy group[(28.23±4.43)%],and the differences were statistically significant(P<0.05).Conclusion Compared with thoracoscopic surgery,Da Vinci robot-assisted radical resection of lung cancer has lower surgical trauma,better postoperative nutritional status and stronger immunity.