Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Otolaryngol Head Neck Surg. 2024 Jul;171(1):254-260. doi: 10.1002/ohn.723. Epub 2024 Mar 15.
Compare surgical and swallow outcomes in robotic versus traditional laryngeal cleft (LC) repairs.
Retrospective cohort study.
Tertiary care pediatric hospital.
Pediatric patients who underwent robotic or traditional (open or endoscopic) LC repair between 2010 and 2021 were identified. Patient characteristics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow study (MBSS) results were compared.
Eighteen robotic and thirty traditional LC repairs were identified. Mean surgical (149 vs 111 min, P < .05) and OR times (207 vs 139 min, P < .002) were increased for robotic type I LC repairs, but were similar for type II and III LC. Mean hospital LOS was increased for robotic type I LC repairs (2.6 vs 1.2 days, P < .006), but was decreased for type II (4 vs 12.2 days) and type III (4.3 vs 94.5 days) LC. Postoperative MBSS results were improved for robotic type I LC repairs at 12 months (82% vs 43%, P = .05), and trended toward improvement at 6 months for type II (75% vs 22%), and type III (67% vs 50%) LC repairs, although significance was limited for type II and III LC due to the number of subjects. A robotic approach was used successfully to revise all recurrent LC that failed traditional repairs.
Robotic type 1 LC repairs demonstrated increased operative times and hospital LOS but improved postoperative swallow outcomes compared to traditional approaches may be particularly useful in cases of recurrent clefts.
比较机器人手术与传统喉裂（LC）修复术的手术和吞咽结果。
回顾性队列研究。
三级儿童医院。
确定了 2010 年至 2021 年间接受机器人或传统（开放或内镜）LC 修复的小儿患者。比较了患者特征、手术时间、不良事件、住院时间（LOS）和改良钡吞咽研究（MBSS）结果。
确定了 18 例机器人和 30 例传统 LC 修复术。机器人Ⅰ型 LC 修复的手术（149 分钟比 111 分钟，P<.05）和手术室时间（207 分钟比 139 分钟，P<.002）较长，但Ⅱ型和Ⅲ型 LC 相似。机器人Ⅰ型 LC 修复的平均住院 LOS 增加（2.6 天比 1.2 天，P<.006），但Ⅱ型（4 天比 12.2 天）和Ⅲ型（4.3 天比 94.5 天）LC 降低。机器人Ⅰ型 LC 修复术后 12 个月的 MBSS 结果改善（82%比 43%，P=.05），Ⅱ型（75%比 22%）和Ⅲ型（67%比 50%）LC 修复的结果也有改善，但由于研究对象数量有限，Ⅱ型和Ⅲ型 LC 的意义有限。机器人方法成功用于修复所有传统修复失败的复发性 LC。
与传统方法相比，机器人Ⅰ型 LC 修复术的手术时间和住院时间延长，但术后吞咽结果改善，可能特别适用于复发性裂隙。
