Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Zhejiang Province, Hangzhou, 310051, China.
Department of Nephrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Zhejiang Province, Taizhou, 318054, China.
Langenbecks Arch Surg. 2023 Dec 26;409(1):18. doi: 10.1007/s00423-023-03208-5.
Robotic surgery is becoming increasingly widely used in the field of pediatric surgery. The present study aimed to evaluate the safety and feasibility of robot-assisted resection of benign pediatric splenic tumors and to discuss the technical points.
A total of 32 patients who were diagnosed with benign splenic tumors and underwent minimally invasive surgery from January 2017 to September 2023 were included in the study. The clinical data including demographic criteria, operative details, and postoperative outcomes were analyzed retrospectively.
Thirteen patients underwent robot-assisted surgery, and 19 patients underwent laparoscopic surgery. The median operation time was 150 min, with an interquartile range (IQR) of 120 to 200 min for the robot-assisted group and 140 min with an IQR of 105 to 180 min in the laparoscopic group (P = 0.318). Despite four cases in the laparoscopic group (21%) being converted to laparotomy because of intraoperative bleeding, compared with none in the robot-assisted group, there was no significant difference between two groups (P = 0.128). The intraoperative volume of blood loss was significantly less (P = 0.041), and the hospitalization expense was significantly higher (P = 0.000) in the robot-assisted group than for the laparoscopic group. There was no significant difference in patients' age, tumor size, postoperative feeding time, and the postoperative hospitalization time between two groups (P > 0.05).
Robot-assisted benign splenic tumor resection was safe and feasible, and it reduced surgical trauma for the pediatric patient.
机器人手术在小儿外科学领域的应用日益广泛。本研究旨在评估机器人辅助切除小儿良性脾肿瘤的安全性和可行性，并探讨相关技术要点。
回顾性分析 2017 年 1 月至 2023 年 9 月期间收治的 32 例经微创治疗、诊断为良性脾肿瘤的患儿的临床资料，包括一般资料、手术细节和术后转归等。
13 例行机器人辅助手术，19 例行腹腔镜手术。机器人辅助组手术时间的中位数为 150 min，IQR 为 120200 min；腹腔镜组手术时间的中位数为 140 min，IQR 为 105180 min（P=0.318）。尽管腹腔镜组有 4 例（21%）因术中出血转为开腹手术，但与机器人辅助组相比，差异无统计学意义（P=0.128）。机器人辅助组术中出血量显著减少（P=0.041），住院费用显著增加（P=0.000）。两组患儿的年龄、肿瘤大小、术后进食时间和术后住院时间差异均无统计学意义（P>0.05）。
机器人辅助切除小儿良性脾肿瘤安全可行，可减轻手术创伤。
