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机器人辅助与传统腹腔镜肾上腺切除术治疗儿童局部肾上腺神经母细胞瘤的比较研究

Robotic assisted versus conventional laparoscopic adrenalectomy for local adrenal neuroblastoma in children: a comparative study.

作者信息

Liu Xiaobo, Sun Yi, Wang Jian, Wu Bin

机构信息

Department of General Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.

Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.

出版信息

Pediatr Surg Int. 2025 Jun 28;41(1):197. doi: 10.1007/s00383-025-06074-y.

Abstract

OBJECTIVE

While some case reports have demonstrated the safety and feasibility of robotic assisted laparoscopic adrenalectomy (RA) for treating local adrenal neuroblastoma (NB) in children, it remains unclear whether RA offers advantages over laparoscopic adrenalectomy (LA) in the pediatric population. This study aimed to compare the perioperative outcomes and efficacy of RA and LA for treating pediatric local adrenal NB.

METHODS

A retrospective analysis was conducted on pediatric patients who underwent minimally invasive adrenalectomy for local adrenal NB in our hospital between May 2012 and April 2024. Among them, 12 patients (6 females, 6 males) underwent LA, while 10 patients (7 females, 3 males) underwent RA. All procedures were performed via a transperitoneal approach.

RESULTS

The RA group exhibited significantly less intraoperative blood loss (p = 0.036), shorter postoperative drainage duration (p = 0.031), and reduced postoperative hospital stay (p = 0.021) compared to the LA group. No statistically significant differences were observed between the two groups in terms of operative time, conversion rate to open surgery, postoperative complications, or intraoperative hemodynamic parameters.

CONCLUSION

Our findings suggest that RA and conventional LA are equally safe and effective for treating local adrenal NB. RA offers advantages over LA, including reduced intraoperative blood loss, shorter postoperative drainage duration, and shorter postoperative hospital stay. However, these findings are preliminary and require confirmation through larger, multicenter studies to establish broader clinical implications.

摘要

目的

虽然一些病例报告已证明机器人辅助腹腔镜肾上腺切除术(RA)治疗儿童局部肾上腺神经母细胞瘤(NB)的安全性和可行性,但在儿科人群中,RA是否比腹腔镜肾上腺切除术(LA)更具优势仍不明确。本研究旨在比较RA和LA治疗小儿局部肾上腺NB的围手术期结果和疗效。

方法

对2012年5月至2024年4月在我院接受微创肾上腺切除术治疗局部肾上腺NB的儿科患者进行回顾性分析。其中,12例患者(6例女性,6例男性)接受了LA,而10例患者(7例女性,3例男性)接受了RA。所有手术均通过经腹途径进行。

结果

与LA组相比,RA组术中出血量显著减少(p = 0.036),术后引流时间缩短(p = 0.031),术后住院时间缩短(p = 0.021)。两组在手术时间、开腹手术转化率、术后并发症或术中血流动力学参数方面未观察到统计学上的显著差异。

结论

我们的研究结果表明,RA和传统LA在治疗局部肾上腺NB方面同样安全有效。RA比LA具有优势,包括减少术中出血量、缩短术后引流时间和缩短术后住院时间。然而,这些发现是初步的,需要通过更大规模的多中心研究加以证实,以确立更广泛的临床意义。

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