PDF(Pubmed)
Abstract：
BACKGROUND: Robot-assisted surgery is increasingly used in children. While robot-assisted surgery in children has been proved to be safe and feasible, use in infants is controversial. The purpose of this study was to present a study of robot-assisted abdominal surgery in children less than5 months of age.
METHODS: A retrospective analysis of 111 patients less than 5 months of age who underwent abdominal surgery from April 2020 to December 2022 in our hospital. The data included clinical information, operative details, and postoperative outcomes.
RESULTS: Among these 111 patients, 67 underwent robot-assisted surgery and 44 underwent laparoscopic-assisted surgery, the robot-assisted group includes 40 patients with Hirschsprung disease, 20 patients with choledochal cysts, and 7 patients with intestinal duplication, the laparoscopic-assisted group includes 26 patients with Hirschsprung disease, 9 patients with choledochal cysts, and 9 patients with intestinal duplication. For Hirschsprung disease, the operation time was significantly longer ( P =0.013) and the intraoperative bleeding was significantly less ( P =0.000) in the robot-assisted group than the laparoscopic assisted group. For choledochal cysts, the median operation time of 180 mins for the robot-assisted group was not significantly longer than the laparoscopic assisted surgery group at 160 mins ( P =0.153). For intestinal duplication, the operation time was significantly longer ( P =0.002) in the robot-assisted group than the laparoscopic assisted group. For these three diseases, the hospitalization expense was significantly higher ( P <0.05) in the robot-assisted group than the laparoscopic assisted group, there were no significant differences in complications, and postoperative fasting time between two groups ( P >0.05).
CONCLUSIONS: Robot-assisted abdominal surgery in children less than 5 months of age is safe and feasible. This study showed that the surgical indications for the Da Vinci robot system in children can be extended to infants.
METHODS: A retrospective analysis of 111 patients less than 5 months of age who underwent abdominal surgery from April 2020 to December 2022 in our hospital. The data included clinical information, operative details, and postoperative outcomes.
RESULTS: Among these 111 patients, 67 underwent robot-assisted surgery and 44 underwent laparoscopic-assisted surgery, the robot-assisted group includes 40 patients with Hirschsprung disease, 20 patients with choledochal cysts, and 7 patients with intestinal duplication, the laparoscopic-assisted group includes 26 patients with Hirschsprung disease, 9 patients with choledochal cysts, and 9 patients with intestinal duplication. For Hirschsprung disease, the operation time was significantly longer ( P =0.013) and the intraoperative bleeding was significantly less ( P =0.000) in the robot-assisted group than the laparoscopic assisted group. For choledochal cysts, the median operation time of 180 mins for the robot-assisted group was not significantly longer than the laparoscopic assisted surgery group at 160 mins ( P =0.153). For intestinal duplication, the operation time was significantly longer ( P =0.002) in the robot-assisted group than the laparoscopic assisted group. For these three diseases, the hospitalization expense was significantly higher ( P <0.05) in the robot-assisted group than the laparoscopic assisted group, there were no significant differences in complications, and postoperative fasting time between two groups ( P >0.05).
CONCLUSIONS: Robot-assisted abdominal surgery in children less than 5 months of age is safe and feasible. This study showed that the surgical indications for the Da Vinci robot system in children can be extended to infants.
摘要：
背景：机器人辅助手术越来越多地用于儿童。虽然机器人辅助儿童手术已被证明是安全可行的，在婴儿中使用是有争议的。这项研究的目的是提出机器人辅助腹部手术在儿童<5个月的研究。
方法：回顾性分析2020年4月至2022年12月在我院行腹部手术的111例<5月龄患者。数据包括临床信息，操作细节,和术后结果。
结果：在这111名患者中，67例接受了机器人辅助手术，44例接受了腹腔镜辅助手术，机器人辅助组包括40例先天性巨结肠病患者，20例胆总管囊肿，和7例肠重复患者，腹腔镜辅助组包括26例先天性巨结肠患者，胆总管囊肿9例,肠重复9例。对于先天性巨结肠病，机器人辅助组手术时间明显长于腹腔镜辅助组(P=0.013),术中出血量明显少于腹腔镜辅助组(P=0.000).胆总管囊肿,机器人辅助组180分钟的中位手术时间与腹腔镜辅助手术组160分钟相比无明显延长(P=0.153).对于肠道重复，机器人辅助组手术时间明显长于腹腔镜辅助组(P=0.002).对于这三种疾病，机器人辅助组住院费用明显高于腹腔镜辅助组(P<0.05),并发症没有显着差异，两组患者术后禁食时间(P>0.05)。
结论：机器人辅助腹部手术在5月龄以下的儿童中是安全可行的。这项研究表明，达芬奇机器人系统在儿童中的手术适应症可以扩展到婴儿。
方法：回顾性分析2020年4月至2022年12月在我院行腹部手术的111例<5月龄患者。数据包括临床信息，操作细节,和术后结果。
结果：在这111名患者中，67例接受了机器人辅助手术，44例接受了腹腔镜辅助手术，机器人辅助组包括40例先天性巨结肠病患者，20例胆总管囊肿，和7例肠重复患者，腹腔镜辅助组包括26例先天性巨结肠患者，胆总管囊肿9例,肠重复9例。对于先天性巨结肠病，机器人辅助组手术时间明显长于腹腔镜辅助组(P=0.013),术中出血量明显少于腹腔镜辅助组(P=0.000).胆总管囊肿,机器人辅助组180分钟的中位手术时间与腹腔镜辅助手术组160分钟相比无明显延长(P=0.153).对于肠道重复，机器人辅助组手术时间明显长于腹腔镜辅助组(P=0.002).对于这三种疾病，机器人辅助组住院费用明显高于腹腔镜辅助组(P<0.05),并发症没有显着差异，两组患者术后禁食时间(P>0.05)。
结论：机器人辅助腹部手术在5月龄以下的儿童中是安全可行的。这项研究表明，达芬奇机器人系统在儿童中的手术适应症可以扩展到婴儿。
