Ihn Kyong, Ho In Geol, Hong Young Ju, Jeon Ho Jong, Lee Dongeun, Han Seok Joo
Department of Pediatric Surgery, Department of Surgery, Severance Children's Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Surgery, Yong-in Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea.
Surg Endosc. 2022 Apr;36(4):2697-2704. doi: 10.1007/s00464-021-08844-w. Epub 2021 Nov 3.
This study aimed to report our experience with a robot-assisted resection of choledochal cysts (CCs) in pediatric patients, especially focusing on changes in outcomes and operative trends.
We retrospectively reviewed medical records of all 158 patients under 18 years of age who underwent robot-assisted resection of CC in a single tertiary center between July 2008 and January 2021. Patients were divided into the first period (P1, July 2008-March 2016; N = 79) and second period (P2, April 2016-January 2021; N = 79) with equal number of participants. The patients of P2 were compared with those of P1 to assess clinical outcomes with operative details. Operative characteristics and postoperative prognosis were compared for each group.
The mean operative time was 383.6 min for the P2 group and 462.6 min for the P1 group (p < 0.001). The mean estimated blood loss was 28 mL in the P2 group and 63 mL in the P1 group (p = 0.025). The rate of emergency department visit after the operation was lower in the P2 group (3.8% vs. 13.9%, respectively, p = 0.047). The two groups showed no significant differences in the rate of late postoperative complications and reoperations.
With the increase in the center's experience, robot-assisted resection of CC can be safely adopted and feasible, especially for pediatric patients.
Treatment Study, Level III.
本研究旨在报告我们在小儿患者中使用机器人辅助切除胆总管囊肿（CCs）的经验，尤其关注结果和手术趋势的变化。
我们回顾性分析了2008年7月至2021年1月期间在单一三级中心接受机器人辅助CC切除的158例18岁以下患者的病历。患者被分为两个时期，每个时期各79例。将第二期（P2，2016年4月至2021年1月）的患者与第一期（P1，2008年7月至2016年3月）的患者进行比较，以评估手术细节和临床结果。比较每组的手术特征和术后预后。
P2组的平均手术时间为383.6分钟，P1组为462.6分钟（p<0.001）。P2组的平均估计失血量为28毫升，P1组为63毫升（p=0.025）。P2组术后急诊就诊率较低（分别为3.8%和13.9%，p=0.047）。两组在术后晚期并发症发生率和再次手术率方面无显著差异。
随着中心经验的增加，机器人辅助CC切除是安全可行的，尤其适用于小儿患者。
治疗研究，III级。
