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机器人辅助小儿肾移植与开放手术对照的结果比较分析及长期随访

Comparative analysis of outcomes and long-term follow-up of robot-assisted pediatric kidney transplantation, with open counterpart.

机构信息

Department of Urology, Uro-oncology, Renal Transplant and Robotics, Max Super Specialty Hospital, New Delhi, India.

出版信息

Pediatr Transplant. 2021 May;25(3):e13917. doi: 10.1111/petr.13917. Epub 2020 Nov 20.

DOI:10.1111/petr.13917
PMID:33217221
Abstract

How does the robotic kidney transplant fare against the open technique, in pediatric patients? No one knows. To address this question, this study compares the outcomes of robotic kidney transplants, with those of open transplant in these patients. This study was a retrospective analysis of outcomes (renal function and complications), of all pediatric patients (<18 years of age), who underwent kidney transplant at our institute, after 2014, till their last follow-up. Fisher's exact test was used to compare proportions. Continuous variables were analyzed using Mann-Whitney test. P value of <.05 was considered significant. Of the twenty-five patients included, 21 belonged to open group, and 4 to the robotic group. Patients in the robotic group had significantly higher Re-WIT (P value .002) and had lower analgesia requirement (P value .04). Median follow-up period was 31 months. Both groups were comparable in terms of length of hospital stay, blood transfusion, and renal function post-operatively till their last follow-up. Three patients in the open group had surgical site infection as compared to none in the robotic group. All the patients had functioning grafts till their last follow-up. Robotic transplant is safe and delivers functional results similar to open technique, with lesser pain and better cosmesis. Longer Re-WIT in robotic transplant has no impact on post-operative renal function. Ours is the first known effort to compare robotic technology with the established open technique of transplant in this population. A prospective randomized controlled trial should refine the results of the present study.

摘要

机器人辅助肾移植在儿科患者中与开放技术相比表现如何?目前尚无人知晓。为了解决这个问题,本研究比较了机器人肾移植和开放移植在这些患者中的结果。本研究是对我院 2014 年后至最后一次随访期间所有接受肾移植的儿科患者(<18 岁)的结局(肾功能和并发症)进行的回顾性分析。使用 Fisher 确切检验比较比例。连续变量采用 Mann-Whitney 检验进行分析。P 值<.05 认为有统计学意义。在 25 名患者中,21 名属于开放组,4 名属于机器人组。机器人组患者的 Re-WIT 明显更高(P 值<.002),镇痛需求更低(P 值<.04)。中位随访时间为 31 个月。两组在住院时间、输血和术后肾功能方面相似,直至最后一次随访。与机器人组相比,开放组有 3 名患者发生手术部位感染,而机器人组无患者发生感染。所有患者在最后一次随访时均有功能移植物。机器人移植是安全的,其功能结果与开放技术相似,疼痛较轻,美容效果更好。机器人移植较长的 Re-WIT 对术后肾功能没有影响。我们的研究是首次尝试在该人群中比较机器人技术与已建立的开放移植技术。前瞻性随机对照试验应进一步完善本研究的结果。

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引用本文的文献

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Comparison of outcomes after open versus robotic kidney transplantation: A systematic review and meta-analysis.开放手术与机器人辅助肾移植术后结局的比较:一项系统评价和荟萃分析。
Indian J Urol. 2023 Jul-Sep;39(3):186-194. doi: 10.4103/iju.iju_390_22. Epub 2023 Jun 30.
2
Pediatric Challenges in Robot-Assisted Kidney Transplantation.机器人辅助肾移植中的儿科挑战
Front Surg. 2021 Mar 25;8:649418. doi: 10.3389/fsurg.2021.649418. eCollection 2021.