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机器人辅助胸腔镜手术治疗儿童纵隔肿瘤:单中心 149 例回顾性研究。

Robot-assisted thoracoscopic surgery for mediastinal tumours in children: a single-centre retrospective study of 149 patients.

机构信息

Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China.

出版信息

Eur J Cardiothorac Surg. 2023 Nov 1;64(5). doi: 10.1093/ejcts/ezad362.

Abstract

OBJECTIVES

The purpose of this retrospective study was to summarize our experience in performing robot-assisted thoracoscopic surgery (RATS) for mediastinal tumours in children to investigate its safety and feasibility.

METHODS

This retrospective study involved 149 patients with mediastinal tumours who were hospitalized in the Department of Thoracic Surgery of Beijing Children's Hospital, Capital Medical University, and underwent RATS for tumour resection from March 2021 to November 2022. Information on patient age, weight, tumour size, surgical incision selection, operative time, intraoperative bleeding, intraoperative complications, length of hospital stay, rate of conversion to thoracotomy and follow-up conditions were summarized.

RESULTS

All 149 surgeries were successfully completed with no cases of mortality. There were 77 male and 72 female patients, with a mean age of 5.9 years (range: 6 months-16 years, 8 months) and a mean weight of 23.6 kg (8.0-72.0 kg). The mean maximum tumour diameter was 5.5 cm (2.0-12.0 cm), the mean operative time was 106.7 min (25.0-260.0 min), the mean intraoperative bleeding volume was 11.3 ml (1.0-400.0 ml) and the mean hospital stay was 7.2 days (4.0-14.0 days). All patients recovered well with no cases of tumour recurrence or mortality during the postoperative follow-up period (3-23 months).

CONCLUSIONS

RATS is safe and feasible to apply in children with mediastinal tumours who are >6 months of age and weigh more than 8 kg in terms of short-term outcomes, but longer-term follow-up is needed to fully evaluate the benefits. For cases that are associated with greater surgical difficulty and risk, a comprehensive surgical plan should be fully prepared in advance of surgery.

摘要

目的

本回顾性研究旨在总结我们在儿童纵隔肿瘤中应用机器人辅助胸腔镜手术(RATS)的经验,以探讨其安全性和可行性。

方法

本回顾性研究纳入了 2021 年 3 月至 2022 年 11 月期间在首都医科大学附属北京儿童医院胸外科住院并接受 RATS 肿瘤切除术的 149 例纵隔肿瘤患儿的临床资料。总结患者年龄、体重、肿瘤大小、手术切口选择、手术时间、术中出血量、术中并发症、住院时间、中转开胸率和随访情况。

结果

所有 149 例手术均顺利完成,无死亡病例。男 77 例,女 72 例;年龄 6 个月至 16 岁,平均年龄 5.9 岁(8 个月);体重 8.0 至 72.0kg,平均 23.6kg。肿瘤最大径 2.0 至 12.0cm,平均 5.5cm;手术时间 25.0 至 260.0min,平均 106.7min;术中出血量 1.0 至 400.0ml,平均 11.3ml;住院时间 4.0 至 14.0d,平均 7.2d。所有患者术后恢复良好,随访 3 至 23 个月,无肿瘤复发或死亡。

结论

对于年龄>6 个月、体重大于 8kg 的儿童纵隔肿瘤患者,短期疗效证实 RATS 安全、可行,但需要更长时间的随访以充分评估其获益。对于手术难度和风险较大的病例,术前应充分准备综合手术方案。

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