Ronconi Di Giuseppe Diana, Claxton Harry, Duhoky Rauand, Piozzi Guglielmo Niccolò, Khan Jim S
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK.
Department of Surgery, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Children (Basel). 2024 Nov 26;11(12):1442. doi: 10.3390/children11121442.
Proper bladder drainage is crucial. Children with bladder dysfunction may require alternative methods like clean intermittent catheterisation (CIC). However, CIC can be challenging for individuals with impairments. The Mitrofanoff procedure provides a solution by connecting the appendix to the bladder and creating a stoma on the skin, allowing for continent catheterisation. Minimally invasive techniques, including robotics, have been adopted recently. The aim of this study is to review the existing literature on robotic Mitrofanoff procedures.
A systematic review on paediatric robotic Mitrofanoff procedures on the PubMed, Cochrane, and Scopus databases was conducted according to the PRISMA Statement. Critical appraisals of the included studies were performed with the Newcastle Ottawa Scale.
Six studies were included about the robotic Mitrofanoff procedure. Sex was reported in 50% of the studies. Ages were within the twelve-year age limit, as per the inclusion criteria. The mean operative time was 499.3 (±171.1) min. Four of the six studies reported a length of stay with a median of 6 days (±4; range 1.8-23). The incidence of complications was in line with established benchmarks. Only one study compared the Mitrofanoff procedure to open surgery, finding similar outcomes but longer operating times. Port placement and surgical strategy was described.
Robotics can offer potential advantages for the Mitrofanoff procedure, despite its application still being in its early stages. This study emphasises the potential safety and efficacy of the robotic approach and promotes the need for further prospective high-quality studies.
正确的膀胱引流至关重要。膀胱功能障碍的儿童可能需要诸如清洁间歇性导尿（CIC）等替代方法。然而，对于有身体障碍的个体而言，CIC可能具有挑战性。米氏术通过将阑尾与膀胱相连并在皮肤上造口，实现可控性导尿，从而提供了一种解决方案。包括机器人技术在内的微创技术近来已被采用。本研究的目的是回顾关于机器人辅助米氏术的现有文献。
根据PRISMA声明，在PubMed、Cochrane和Scopus数据库上对儿科机器人辅助米氏术进行了系统评价。使用纽卡斯尔渥太华量表对纳入研究进行严格评价。
纳入了六项关于机器人辅助米氏术的研究。50%的研究报告了性别。根据纳入标准，年龄在12岁年龄限制内。平均手术时间为499.3（±171.1）分钟。六项研究中的四项报告了住院时间，中位数为6天（±4；范围1.8 - 23）。并发症发生率符合既定标准。只有一项研究将米氏术与开放手术进行了比较，发现结果相似，但手术时间更长。描述了端口放置和手术策略。
尽管机器人技术在米氏术中的应用仍处于早期阶段，但它可能具有潜在优势。本研究强调了机器人手术方法的潜在安全性和有效性，并提出了进一步开展前瞻性高质量研究的必要性。
