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儿童胆总管囊肿的机器人辅助手术:越南国家儿童医院的早期经验

Robotic-assisted surgery for choledochal cyst in children: early experience at Vietnam National Children's Hospital.

作者信息

Pham Hien Duy, Okata Yuichi, Vu Hoan Manh, Tran Nam Xuan, Nguyen Quang Thanh, Nguyen Liem Thanh

机构信息

Department of Pediatric Surgery, Vietnam National Children's Hospital, 18/879 La Thanh, Dong Da, Hanoi, Vietnam.

Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

Pediatr Surg Int. 2019 Nov;35(11):1211-1216. doi: 10.1007/s00383-019-04518-w. Epub 2019 Jul 3.

Abstract

PURPOSE

We aimed to describe our robotic-assisted surgery (RAS) techniques and assess the early results of RAS for choledochal cysts in children.

METHODS

We conducted a retrospective chart review of children who underwent RAS for a congenital choledochal cyst at our institution between February 2013 and August 2016. We analyzed patient characteristics, operative data, and postoperative outcomes.

RESULTS

Thirty-nine patients underwent RAS for a choledochal cyst (female 30). The operation was performed with four robotic ports and one laparoscopic port for the assistant. The Roux loop was fashioned extracorporeally. Twenty patients (51.3%) had a Todani Type I cyst and the others had Type IV. The mean patient age and weight and choledochal cyst diameter at the time of the operation were 40.2 months (range 5-108 months), 13.4 kg (range 6.5-29 kg), and 27.2 mm (range 9-112 mm), respectively. The mean operating time was 192.7 min (range 150-330 min). There were no intraoperative complications; no conversions to laparoscopic or open surgery; and no postoperative complications, including cholangitis, cholelithiasis, or anastomotic stenosis.

CONCLUSION

Pediatric RAS CC resection is safe and feasible. The robot-assisted technique overcame technical difficulties. However, in pediatric cases, a skilled robotic surgical team and procedural modifications are needed.

摘要

目的

我们旨在描述我们的机器人辅助手术(RAS)技术,并评估儿童胆总管囊肿RAS的早期结果。

方法

我们对2013年2月至2016年8月期间在我院接受先天性胆总管囊肿RAS手术的儿童进行了回顾性病历审查。我们分析了患者特征、手术数据和术后结果。

结果

39例患者接受了胆总管囊肿RAS手术(女性30例)。手术通过四个机器人端口和一个用于助手的腹腔镜端口进行。Roux袢在体外制作。20例(51.3%)患者为Todani I型囊肿,其他为IV型。手术时患者的平均年龄、体重和胆总管囊肿直径分别为40.2个月(范围5 - 108个月)、13.4千克(范围6.5 - 29千克)和27.2毫米(范围9 - 112毫米)。平均手术时间为192.7分钟(范围150 - 330分钟)。术中无并发症;无转为腹腔镜或开放手术的情况;术后也无并发症,包括胆管炎、胆石症或吻合口狭窄。

结论

小儿RAS胆总管囊肿切除术是安全可行的。机器人辅助技术克服了技术难题。然而,在小儿病例中,需要熟练的机器人手术团队和手术方式的改进。

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