Abstract：
BACKGROUND: Robotic-assisted minimally invasive surgery (RA-MIS) for tumor resection is an emerging technology in the pediatric population with significant promise but unproven safety and feasibility.
METHODS: A multi-center retrospective review of patients ≤18 years undergoing RA-MIS tumor resection from December 2015-March 2023 was performed. Patient demographics, perioperative variables, and complication rates were analyzed.
RESULTS: Thirty-nine procedures were performed on 38 patients (17 thoracic, 22 abdominal); 37% female and 68% non-Hispanic White. Median age at surgery was 8.3 years (IQR 5.7, 15.7); the youngest was 1.7 years-old. Thoracic operations included resections of neuroblastic tumors (n = 16) and a single paraganglioma. The most common abdominal operations included resections of neuroblastic tumors (n = 5), pheochromocytomas (n = 3), and angiomyolipomas (n = 3). Six patients underwent retroperitoneal lymph node dissection (RPLND) for paratesticular tumors. Median operating time for the cohort was 2:52 h (IQR 2:04, 4:31). Two thoracic cases required open conversion due to poor visualization and lack of working domain. All patients underwent complete tumor resection; one had tumor spillage from a positive margin (Wilms tumor). Median LOS was 1.5 days (IQR 1.1, 3.0). Postoperatively, one patient developed a chyle leak requiring interventional radiology drainage, but none required a return to the operating room.
CONCLUSIONS: Robotic-assisted surgery is safe and feasible for tumor resection in carefully selected pediatric patients, achieving complete resection with minimal morbidity and short LOS. Resection should be performed by those with robotic expertise for optimal outcomes.
METHODS: IV.
METHODS: Original Clinical Research.
METHODS: A multi-center retrospective review of patients ≤18 years undergoing RA-MIS tumor resection from December 2015-March 2023 was performed. Patient demographics, perioperative variables, and complication rates were analyzed.
RESULTS: Thirty-nine procedures were performed on 38 patients (17 thoracic, 22 abdominal); 37% female and 68% non-Hispanic White. Median age at surgery was 8.3 years (IQR 5.7, 15.7); the youngest was 1.7 years-old. Thoracic operations included resections of neuroblastic tumors (n = 16) and a single paraganglioma. The most common abdominal operations included resections of neuroblastic tumors (n = 5), pheochromocytomas (n = 3), and angiomyolipomas (n = 3). Six patients underwent retroperitoneal lymph node dissection (RPLND) for paratesticular tumors. Median operating time for the cohort was 2:52 h (IQR 2:04, 4:31). Two thoracic cases required open conversion due to poor visualization and lack of working domain. All patients underwent complete tumor resection; one had tumor spillage from a positive margin (Wilms tumor). Median LOS was 1.5 days (IQR 1.1, 3.0). Postoperatively, one patient developed a chyle leak requiring interventional radiology drainage, but none required a return to the operating room.
CONCLUSIONS: Robotic-assisted surgery is safe and feasible for tumor resection in carefully selected pediatric patients, achieving complete resection with minimal morbidity and short LOS. Resection should be performed by those with robotic expertise for optimal outcomes.
METHODS: IV.
METHODS: Original Clinical Research.
摘要：
背景：机器人辅助的微创手术（RA-MIS）在儿科人群中是一种新兴的技术，具有巨大的前景，但安全性和可行性未经证实。
方法：对2015年12月至2023年3月接受RA-MIS肿瘤切除术的≤18岁患者进行多中心回顾性研究。患者人口统计学，围手术期变量，并对并发症发生率进行分析。
结果：对38例患者进行了39次手术（17例胸部，22腹部）；37%的女性和68%的非西班牙裔白人。手术的中位年龄为8.3岁（IQR5.7，15.7）；最小的是1.7岁。胸外科手术包括切除神经母细胞瘤（n=16）和单个副神经节瘤。最常见的腹部手术包括神经母细胞瘤的切除（n=5），嗜铬细胞瘤（n=3），和血管平滑肌脂肪瘤（n=3）。6例患者接受腹膜后淋巴结清扫术（RPLND）治疗睾丸旁肿瘤。队列的中位手术时间为2:52h(IQR2:04,4:31)。由于可视化不良和缺乏工作域，两个胸部病例需要开放转换。所有患者均接受了完整的肿瘤切除术；其中一个肿瘤从阳性切缘溢出（Wilms肿瘤）。中位LOS为1.5天(IQR1.1,3.0)。术后,一名患者出现乳糜渗漏，需要介入放射学引流，但没有人需要回手术室.
结论：机器人辅助手术对于精心挑选的儿科患者的肿瘤切除是安全可行的，以最小的发病率和短LOS实现完全切除。切除应由具有机器人专业知识的人员进行，以获得最佳结果。
方法：IV.
方法：原始临床研究。
方法：对2015年12月至2023年3月接受RA-MIS肿瘤切除术的≤18岁患者进行多中心回顾性研究。患者人口统计学，围手术期变量，并对并发症发生率进行分析。
结果：对38例患者进行了39次手术（17例胸部，22腹部）；37%的女性和68%的非西班牙裔白人。手术的中位年龄为8.3岁（IQR5.7，15.7）；最小的是1.7岁。胸外科手术包括切除神经母细胞瘤（n=16）和单个副神经节瘤。最常见的腹部手术包括神经母细胞瘤的切除（n=5），嗜铬细胞瘤（n=3），和血管平滑肌脂肪瘤（n=3）。6例患者接受腹膜后淋巴结清扫术（RPLND）治疗睾丸旁肿瘤。队列的中位手术时间为2:52h(IQR2:04,4:31)。由于可视化不良和缺乏工作域，两个胸部病例需要开放转换。所有患者均接受了完整的肿瘤切除术；其中一个肿瘤从阳性切缘溢出（Wilms肿瘤）。中位LOS为1.5天(IQR1.1,3.0)。术后,一名患者出现乳糜渗漏，需要介入放射学引流，但没有人需要回手术室.
结论：机器人辅助手术对于精心挑选的儿科患者的肿瘤切除是安全可行的，以最小的发病率和短LOS实现完全切除。切除应由具有机器人专业知识的人员进行，以获得最佳结果。
方法：IV.
方法：原始临床研究。
