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我们在小儿患者中进行机器人辅助腹腔镜手术的经验:来自土耳其的首个病例系列。

Our experiences with robot- assisted laparoscopic surgery in pediatric patients: the first case series from Turkey.

作者信息

Kibar Yusuf, Yalçın Serdar, Kaya Engin, Köprü Burak, Ebiloğlu Turgay, Ergin Giray, Tomruk Hüseyin

机构信息

Department of Urology, Koru Hospital, Ankara, Turkey.

Department of Urology, Gülhane Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Urol. 2017 Sep;43(3):355-360. doi: 10.5152/tud.2017.88303. Epub 2017 Aug 1.

Abstract

OBJECTIVE

Robotic surgery is a leading treatment option for minimally invasive surgery and has an increasing popularity in pediatric population, as well. In this article, we reported our case series of robot-assisted laparoscopic surgery in pediatric population.

MATERIAL AND METHODS

We retrospectively reviewed 29 consecutive pediatric patients who underwent robot- assisted procedures between May 2014 and October 2016. Patient demographics, hospitalization time, estimated blood loss, robotic time and total operative and peri-, and post-operative complications were evaluated.

RESULTS

A total of 24 ureter units (18 patients) with grade 1-5 vesicoureteral reflux in 13 female and 5 male, 1 male patient with vesicoureteral stenosis were underwent robot- assisted laparoscopic ureteral reimplantation (RALUR). All patients had complete resolution after surgery. Robot-assisted laparoscopic pyeloplasty (RALP) was performed in 6 patients with ureteropelvic junction obstruction. All patients had complete resolution after surgery. Completely intracorporeal robotic assisted laparoscopic augmentation ileocystoplasty (RLAIC) was applied to two patients with neurogenic bladder. The symptoms and preoperative hydronephrosis were regressed on the first month of follow-up. Robot-assisted laparoscopic reduction cystoplasty (RALRC) was performed in 14-year-old boy with a bladder diverticula and recurrent urinary tract infection. The last case was eleven- year-old female patient with non-functioning kidney. She had recurrent urinary tract infections and was treated with robotic assisted laparoscopic nephrectomy (RALN).

CONCLUSION

Robot-assisted laparoscopic surgery is safe and efficient in pediatric population. Although open surgery is still the gold standard for many pediatric diseases, inherent reconstructive advantages of robotic assisted laparoscopy have a chance to change this view.

摘要

目的

机器人手术是微创手术的主要治疗选择,在儿科患者中也越来越受欢迎。在本文中,我们报告了我们在儿科患者中进行机器人辅助腹腔镜手术的病例系列。

材料与方法

我们回顾性分析了2014年5月至2016年10月期间连续接受机器人辅助手术的29例儿科患者。评估了患者的人口统计学资料、住院时间、估计失血量、机器人手术时间以及总的手术时间和围手术期及术后并发症。

结果

共有24个输尿管单位(18例患者),其中13例女性和5例男性患有1-5级膀胱输尿管反流,1例男性患者患有膀胱输尿管狭窄,接受了机器人辅助腹腔镜输尿管再植术(RALUR)。所有患者术后均完全康复。6例输尿管肾盂连接部梗阻患者接受了机器人辅助腹腔镜肾盂成形术(RALP)。所有患者术后均完全康复。两名神经源性膀胱患者接受了完全体内机器人辅助腹腔镜回肠膀胱扩大术(RLAIC)。随访第一个月时症状和术前肾积水有所减轻。一名患有膀胱憩室和反复尿路感染的14岁男孩接受了机器人辅助腹腔镜膀胱缩小成形术(RALRC)。最后一例是一名11岁的无功能肾女性患者。她反复尿路感染,接受了机器人辅助腹腔镜肾切除术(RALN)治疗。

结论

机器人辅助腹腔镜手术在儿科患者中是安全有效的。尽管开放手术仍是许多儿科疾病的金标准,但机器人辅助腹腔镜手术固有的重建优势有机会改变这一观点。

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