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.	钟文昭, 中国胸部肿瘤研究协作组, 中国抗癌协会肺癌专业委员会, 等. 肺癌多学科团队诊疗中国专家共识. 中华肿瘤杂志, 2020, 42(10): 817-828.
2.	傅睿, 吴一龙, 钟文昭. 2020版肺癌多学科团队诊疗中国专家共识解读. 中国肿瘤临床, 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.
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5.	刘宝东, 支修益. 肺结节、肺癌的一站式管理—从多学科团队到多学科医生. 中国胸心血管外科临床杂志, 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.	徐洪丽, 魏少忠. 多学科诊疗模式在湖北省肿瘤医院的实践. 肿瘤防治研究, 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.	温倩南, 李悦娴, 孙德峰. 加速康复外科理念下麻醉管理的研究进展. 中国医师杂志, 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, 许世广, 徐惟, 等. 机器人辅助与电视辅助胸腔镜手术治疗非小细胞肺癌近远期生存差异的回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(9): 1133-1139.
17.	兰轲, 周健, 郭海华, 等. 基于TM&M分级系统肺癌胸腔镜肺主要手术并发症列线图预测模型的建立和验证. 中国肺癌杂志, 2021, 24(12): 838-846.
18.	孙琛, 孙晓杰, 王家林, 等. 肿瘤多学科协作诊疗模式的发展现状及评价研究进展. 中国医院管理, 2022, 42(8): 53-56.
19.	中国抗癌协会肺癌专业委员会, 中华医学会肿瘤学分会肺癌学组. Ⅲ期非小细胞肺癌多学科诊疗专家共识 (2019版). 中华肿瘤杂志, 2019, 41(12): 881-890.
20.	中国医师协会肿瘤医师分会, 中国医疗保健国际交流促进会肿瘤内科分会. 中国Ⅳ期原发性肺癌多学科团队诊疗实施指南. 中华肿瘤杂志, 2022, 44(7): 667-672.

1. 钟文昭, 中国胸部肿瘤研究协作组, 中国抗癌协会肺癌专业委员会, 等. 肺癌多学科团队诊疗中国专家共识. 中华肿瘤杂志, 2020, 42(10): 817-828.
2. 傅睿, 吴一龙, 钟文昭. 2020版肺癌多学科团队诊疗中国专家共识解读. 中国肿瘤临床, 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. 刘宝东, 支修益. 肺结节、肺癌的一站式管理—从多学科团队到多学科医生. 中国胸心血管外科临床杂志, 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. 徐洪丽, 魏少忠. 多学科诊疗模式在湖北省肿瘤医院的实践. 肿瘤防治研究, 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. 温倩南, 李悦娴, 孙德峰. 加速康复外科理念下麻醉管理的研究进展. 中国医师杂志, 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, 许世广, 徐惟, 等. 机器人辅助与电视辅助胸腔镜手术治疗非小细胞肺癌近远期生存差异的回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(9): 1133-1139.
17. 兰轲, 周健, 郭海华, 等. 基于TM&M分级系统肺癌胸腔镜肺主要手术并发症列线图预测模型的建立和验证. 中国肺癌杂志, 2021, 24(12): 838-846.
18. 孙琛, 孙晓杰, 王家林, 等. 肿瘤多学科协作诊疗模式的发展现状及评价研究进展. 中国医院管理, 2022, 42(8): 53-56.
19. 中国抗癌协会肺癌专业委员会, 中华医学会肿瘤学分会肺癌学组. Ⅲ期非小细胞肺癌多学科诊疗专家共识 (2019版). 中华肿瘤杂志, 2019, 41(12): 881-890.
20. 中国医师协会肿瘤医师分会, 中国医疗保健国际交流促进会肿瘤内科分会. 中国Ⅳ期原发性肺癌多学科团队诊疗实施指南. 中华肿瘤杂志, 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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