Visconti Irene Claudia, Reale Marella, Dallari Virginia, Trecca Eleonora M C, Di Lullo Antonella Miriam, Turri-Zanoni Mario, Gaffuri Michele
GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology-Head and Neck Surgery, 00162 Rome, Italy.
Otorhinolaryngology Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, 47121 Forlì, Italy.
Children (Basel). 2025 Jun 13;12(6):765. doi: 10.3390/children12060765.
: This review summarizes current evidence on robotic-assisted upper airway and neck surgery in pediatric patients, highlighting clinical indications, outcomes, limitations, and areas for future research. : A systematic review was conducted in accordance with PRISMA guidelines, including studies on robotic surgery for pediatric patients (≤18 years) with upper airway conditions and cervical pathologies. Data on study characteristics, patient demographics, surgical details, outcomes, and robotic system advantages or limitations were extracted. : Twenty studies met inclusion criteria, comprising 104 pediatric patients who underwent 110 robotic procedures, mostly transoral robotic surgery (TORS) for base of tongue, laryngeal, and cervical pathologies. The Da Vinci Si was the most used system. The mean operative time was ~74 min, with minimal blood loss and no intra/post operative tracheostomies. Reported advantages included enhanced visualization, precision, and reduced morbidity. Limitations involved size mismatches, limited working space, and high costs. Follow-up (mean 11.4 months) revealed no recurrences, confirming feasibility and safety in selected pediatric cases. : Robotic-assisted surgery appears to be a feasible and safe option for managing pediatric upper airway and neck conditions, offering promising functional and aesthetic outcomes with low complication rates. However, its use is currently limited by anatomical constraints, high costs, and the need for surgeon training. Long-term prospective studies with larger cohorts are needed to confirm its efficacy and define its role compared to traditional techniques.
本综述总结了目前关于小儿患者机器人辅助上呼吸道和颈部手术的证据，重点介绍了临床适应症、结果、局限性以及未来研究的领域。按照PRISMA指南进行了一项系统综述，纳入了关于机器人手术治疗患有上呼吸道疾病和颈部病变的小儿患者（≤18岁）的研究。提取了关于研究特征、患者人口统计学、手术细节、结果以及机器人系统优势或局限性的数据。20项研究符合纳入标准，包括104例小儿患者，他们接受了110例机器人手术，大部分是经口机器人手术（TORS），用于治疗舌根、喉部和颈部病变。达芬奇Si是使用最多的系统。平均手术时间约为74分钟，出血量极少，术中/术后均未行气管切开术。报告的优势包括视野增强、精度提高和发病率降低。局限性包括尺寸不匹配、工作空间有限和成本高昂。随访（平均11.4个月）显示无复发，证实了在选定小儿病例中的可行性和安全性。机器人辅助手术似乎是治疗小儿上呼吸道和颈部疾病的一种可行且安全的选择，具有良好的功能和美学效果，并发症发生率低。然而，目前其应用受到解剖学限制、高成本以及外科医生培训需求的限制。需要进行更大样本量的长期前瞻性研究，以证实其疗效，并确定其与传统技术相比的作用。
