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机器人辅助儿童肠重复畸形切除术

Robot-Assisted Resection of Intestinal Duplication in Children.

作者信息

Jin Yi, Zhang Yuebin, Cai Duote, Huang Zongwei, Zhang Shuhao, Mao Jianhua, Gao Zhigang

机构信息

Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2022 Dec;32(12):1288-1292. doi: 10.1089/lap.2022.0173. Epub 2022 Jul 29.

Abstract

Intestinal duplication is the most common type of alimentary tract duplications in childhood. Laparoscopic-assisted surgery has become the main surgical procedure, but robot-assisted resection has rarely been reported; the aim of this study was to retrospectively present our experience with robot-assisted intestinal duplication excision using the Da Vinci Xi surgical system and discuss the technical points. In total, 49 patients who were diagnosed with intestinal duplication and underwent surgery from April 2020 to February 2022 in the Children's Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. The data were collected including the clinical information of the patients, operative details, and postoperative outcomes. Among these 49 patients, a total of 15 underwent robot-assisted surgery and 34 underwent laparoscopic-assisted surgery. For the robot-assisted surgery group, all the cysts were peeled off by complete endoscope, the integrity of the intestine was preserved and intestinal resection and anastomosis were not required. The operation time of 80 minutes for the robot-assisted group was not significantly longer than the 90 minutes for the laparoscopic-assisted surgery group( > .05), but the mean time to take the liquid diet after surgery and the average length of postoperative hospital stay were significantly shorter ( < .05). Robot-assisted resection of intestinal duplication is safe and feasible and the refinement of the Da Vinci Xi surgical system was much better than that of the conventional laparoscopic equipment, resulting in significantly improved intraoperative and postoperative outcomes.

摘要

肠重复畸形是儿童期最常见的消化道重复畸形类型。腹腔镜辅助手术已成为主要的手术方式,但机器人辅助切除术鲜有报道;本研究的目的是回顾性介绍我们使用达芬奇Xi手术系统进行机器人辅助肠重复畸形切除术的经验,并讨论技术要点。对2020年4月至2022年2月在浙江大学医学院附属儿童医院诊断为肠重复畸形并接受手术的49例患者进行了回顾性分析。收集了患者的临床信息、手术细节和术后结果等数据。在这49例患者中,共有15例接受了机器人辅助手术,34例接受了腹腔镜辅助手术。对于机器人辅助手术组,所有囊肿均通过完全内镜剥离,保留了肠管的完整性,无需进行肠切除和吻合。机器人辅助组80分钟的手术时间并不显著长于腹腔镜辅助手术组的90分钟(P>0.05),但术后开始进流食的平均时间和术后住院平均天数显著缩短(P<0.05)。机器人辅助肠重复畸形切除术安全可行,达芬奇Xi手术系统的精细程度远优于传统腹腔镜设备,显著改善了术中及术后结果。

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