Liang Liang, Tan Zheng, Huang Ting, Gao Yue, Zhang Jian, Yu Jiangen, Xia Jie, Shu Qiang
Department of Thoracic Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
Department of Cardiac surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
World J Pediatr Surg. 2024 Aug 1;7(2):e000748. doi: 10.1136/wjps-2023-000748. eCollection 2024.
This study was performed to evaluate the efficacy of robot-assisted thoracoscopic surgery (RATS) in the treatment of pulmonary sequestration (PS) in children.
All video-assisted thoracoscopic surgery (VATS) and RAST performed on patients with PS at a single center from May 2019 to July 2023 were identified. The and Wilcoxon tests were used to compare the perioperative outcomes between VATS and RATS groups.
Ninety-three patients underwent RATS while 77 patients underwent VATS. In both two groups, one patient converted to thoracotomy and no surgical mortality case. The median operation time was longer for the RATS group compared with the VATS group (75 min 60 min, <0.001). A lower ratio of chest tube indwelling (61.3% 90.9%, <0.001), fewer drainage days (1.0 day 2.0 days, <0.001), and a shorter postoperative length of stay (5.0 days 6.0 days, <0.001) were found in the RATS group than that in the VATS group. No significant difference was found in the incidence of short-term postoperative complications (hydrothorax and pneumothorax) between two groups.
RATS was safe and effective in children with PS over 6 months old and more than 7 kg. Furthermore, RATS led to better short-time postoperative outcome than VATS. Multi-institutional studies are warranted to compare differences in long-term outcomes between RATS and VATS.
本研究旨在评估机器人辅助胸腔镜手术(RATS)治疗儿童肺隔离症(PS)的疗效。
确定2019年5月至2023年7月在单一中心对PS患者进行的所有电视辅助胸腔镜手术(VATS)和RATS手术。采用 和Wilcoxon检验比较VATS组和RATS组的围手术期结果。
93例患者接受了RATS手术,77例患者接受了VATS手术。两组均有1例患者转为开胸手术,无手术死亡病例。RATS组的中位手术时间比VATS组长(75分钟对60分钟,<0.001)。RATS组的胸管留置率较低(61.3%对90.9%,<0.001),引流天数较少(1.0天对2.0天,<0.001),术后住院时间较短(5.0天对6.0天,<0.001)。两组术后短期并发症(胸腔积液和气胸)的发生率无显著差异。
RATS对6个月以上、体重超过7 kg的PS儿童患者安全有效。此外,RATS术后短期效果优于VATS。需要进行多机构研究以比较RATS和VATS在长期结果上的差异。