开放肾盂成形术中错过交叉血管：机器人辅助手术在儿童中的潜在优势。
The missed crossing vessel during open pyeloplasty: a potential advantage of the robot-assisted approach in children.
机构信息
Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 34th Street and Civic Center Blvd., 337 Laurel Lane, Philadelphia, PA, 19104, USA.
Division of Urology, North Estonia Medical Center, J. Sütiste Tee 19, Tallinn, Estonia.
出版信息
J Robot Surg. 2024 Jul 16;18(1):285. doi: 10.1007/s11701-024-02006-5.
OBJECTIVE
To investigate whether the panoramic view offered by robot-assisted laparoscopic pyeloplasty (RALP) reduces the likelihood of missing a crossing vessel compared to open pyeloplasty in cases where initial pyeloplasty fails.
METHODS
A single institution redo-pyeloplasty database was reviewed for children treated between January 2012 to July 2023. Clinical history, imaging and operative details were reviewed to identify the etiology for the redo procedure.
RESULTS
Cohort consisted of 45 patients undergoing a redo RALP during the study period. 29 of 45 patients had an initial open surgical approach, whereas 16 had an initial RALP. 10 patients were noted to have a missed crossing vessel on redo pyeloplasty - 9 had an initial open approach whereas 1 had an initial RALP (p<0.0001).
CONCLUSIONS
RALP may reduce the risk of missing a crossing vessel due to the panoramic view of the surgical field intrinsic to an intraperitoneal RALP approach.
目的
研究在初始肾盂成形术失败的情况下，与开放肾盂成形术相比，机器人辅助腹腔镜肾盂成形术（RALP）提供的全景视图是否降低了错过交叉血管的可能性。
方法
对 2012 年 1 月至 2023 年 7 月期间在一家机构接受治疗的儿童进行了单中心再手术肾盂成形术数据库的回顾性研究。回顾临床病史、影像学和手术细节，以确定再手术的病因。
结果
研究期间，45 例患者接受了再 RALP 手术。45 例患者中，29 例为初始开放性手术，16 例为初始 RALP。10 例患者在再肾盂成形术中发现有交叉血管漏诊 - 9 例为初始开放性手术，1 例为初始 RALP（p<0.0001）。
结论
RALP 可能通过其腹腔内 RALP 方法固有的手术视野全景视图降低错过交叉血管的风险。
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