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儿童胃食管反流病行机器人辅助腹腔镜与传统腹腔镜 Nissen 胃底折叠术治疗效果的文献回顾。

A literature review of the outcomes after robot-assisted laparoscopic and conventional laparoscopic Nissen fundoplication for gastro-esophageal reflux disease in children.

机构信息

Department of Pediatric Surgery, Skane University Hospital in Lund, and Lund University, 22185, Lund, Sweden.

出版信息

Int J Med Robot. 2013 Dec;9(4):428-32. doi: 10.1002/rcs.1517. Epub 2013 Jun 26.

Abstract

BACKGROUND

Robot-assisted surgery is a promising technical innovation. Given the similarities between laparoscopic and robot-assisted surgery it is unlikely that randomized controlled trials would be conducted to disclose any differences between these two technical instruments. Thus, skepticism remains due to lack of any definitive conclusions in the literature.

AIMS

The aim of the study was to disclose any difference in outcome after robot-assisted (RNF) versus conventional laparoscopic (LNF) Nissen fundoplication for gastro-esophageal reflux disease in children.

MATERIALS AND METHODS

A literature review was carried out. Only studies comparing the two modalities were included. Operative time, duration of hospital stay, 30 days morbidity, mortality, conversion, recurrence and complication rates were analyzed. Review Manager 5.1.6 software, from the Cochrane library, was used for statistical analysis.

RESULTS

Three case series fulfilled the criteria for inclusion in this review. Data on 174 children were identified; 89 were operated on using the computer-assisted technology and 85 controls were operated on using the conventional laparoscopic technique. Data showed no significant difference between these two modalities.

DISCUSSION

This literature review demonstrates no significant difference between patients operated on with robot-assisted surgery and those undergoing conventional laparoscopic surgery regarding the parameters studied.

CONCLUSION

The robot-assisted Nissen fundoplication in children is a safe alternative to conventional laparoscopic surgery. No data support the need for case selection to one of these two minimally invasive procedures.

摘要

背景

机器人辅助手术是一项有前途的技术创新。鉴于腹腔镜和机器人辅助手术之间的相似性,不太可能进行随机对照试验来揭示这两种技术仪器之间的任何差异。因此,由于文献中缺乏明确的结论,仍然存在怀疑。

目的

本研究旨在揭示儿童胃食管反流病行机器人辅助(RNF)与传统腹腔镜(LNF)Nissen 胃底折叠术的结果差异。

材料和方法

进行了文献回顾。仅包括比较两种方法的研究。分析了手术时间、住院时间、30 天发病率、死亡率、转换率、复发率和并发症发生率。使用 Cochrane 图书馆的 Review Manager 5.1.6 软件进行统计分析。

结果

有三项病例系列符合本综述的纳入标准。共确定了 174 名儿童的数据;89 名儿童使用计算机辅助技术进行手术,85 名对照儿童使用传统腹腔镜技术进行手术。数据显示这两种方法之间没有显著差异。

讨论

本文献综述表明,在研究的参数方面,接受机器人辅助手术的患者与接受传统腹腔镜手术的患者之间没有显著差异。没有数据支持对这两种微创手术之一进行病例选择的必要性。

结论

儿童机器人辅助 Nissen 胃底折叠术是传统腹腔镜手术的安全替代方法。

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