儿童结直肠机器人辅助手术。长期疗效与陷阱
Colorectal Robotic-Assisted Surgery in Children. Long-Term Outcomes and Pitfalls.
作者信息
Delgado-Miguel Carlos, Reparaz Laura, Clarkson Wright, Desai Karina, Camps Juan I
机构信息
Department of Pediatric Surgery, Prisma Health Children's Hospital, Columbia, South Carolina, USA.
Institute for Health Research IdiPAZ, La Paz University Hospital, Madrid, Spain.
出版信息
Int J Med Robot. 2024 Dec;20(6):e70032. doi: 10.1002/rcs.70032.
BACKGROUND
Colorectal surgical procedures may benefit from a minimally invasive approach in children, although there are few studies.
METHODS
A retrospective, single-centre observational study was conducted on paediatric patients who underwent colorectal robotic-assisted surgery between 2011 and 2022.
RESULTS
A total of 50 patients (33 male; 17 female) were included, with a median age of 4.8 years (IQR:2.5-6.3 years). The main indication was robotic Soave pull-through for Hirschsprung's disease in 21 cases. No conversions or intraoperative complications were reported. Operative time varied depending on the procedure, with a median of 183 min (IQR:151-224 min). Median hospital stay was 4 days (IQR:3-5 days). Four postoperative complications were observed, two of them Clavien-Dindo IIIb (one colo-anal partial dehiscence and one anastomotic leak after megasigmoid resection). Regarding long-term follow-up (median 7.6 years; IQR:4.8-10.6 years), 4 patients (8%) required surgical reintervention.
CONCLUSION
Colorectal robotic-assisted surgery encompasses several procedures with low complication rates and satisfactory long-term outcomes.
背景
尽管相关研究较少，但结直肠手术采用微创方法可能对儿童有益。
方法
对2011年至2022年间接受结直肠机器人辅助手术的儿科患者进行了一项回顾性单中心观察性研究。
结果
共纳入50例患者（男33例；女17例），中位年龄4.8岁（四分位间距：2.5 - 6.3岁）。主要适应证为21例机器人辅助Soave拖出术治疗先天性巨结肠。未报告中转开腹或术中并发症。手术时间因手术方式而异，中位时间为183分钟（四分位间距：151 - 224分钟）。中位住院时间为4天（四分位间距：3 - 5天）。观察到4例术后并发症，其中2例为Clavien-Dindo IIIb级（1例结肠肛管部分裂开，1例巨乙状结肠切除术后吻合口漏）。关于长期随访（中位时间7.6年；四分位间距：4.8 - 10.6年），4例患者（8%）需要再次手术干预。
结论
结直肠机器人辅助手术涵盖多种手术，并发症发生率低，长期效果令人满意。
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