PDF(Pubmed)
Abstract：
BACKGROUND: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and recent developments in the reductions in port sizes and single-port surgery offer promising prospects. This study aimed to present a systematic overview and analysis of the existing literature around the use of robotic platforms in the treatment of paediatric gastrointestinal diseases.
METHODS: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale.
RESULTS: Fifteen studies were included, of which seven were on Hirschsprung\'s disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, p < 0.001), but no significant differences in blood loss, length of stay, intraoperative complications, postoperative complications, or conversion.
CONCLUSIONS: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery.
METHODS: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale.
RESULTS: Fifteen studies were included, of which seven were on Hirschsprung\'s disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, p < 0.001), but no significant differences in blood loss, length of stay, intraoperative complications, postoperative complications, or conversion.
CONCLUSIONS: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery.
摘要：
背景：自2000年代初以来，在儿科手术中使用微创手术（MIS）一直在增加，并且由于儿科手术特有的因素而变得复杂。机器人手术的兴起为儿童MIS提供了机会，以及最近在减少端口尺寸和单端口手术方面的发展提供了有希望的前景。本研究旨在对有关使用机器人平台治疗小儿胃肠道疾病的现有文献进行系统的概述和分析。
方法：根据PRISMA声明，在Pubmed，科克伦,还有Scopus.使用纽卡斯尔渥太华量表对研究进行了严格的评估。
结果：纳入了15项研究，其中7人患有先天性巨结肠病，8人患有其他适应症。纳入的研究在他们的人群中是异质的，年龄,和性,但所有机器人队列的术中并发症和转换发生率均较低.只有一项研究报告了一个比较队列，在机器人队列中手术时间更长(180与152和156分钟，p<0.001)，但在失血方面没有显著差异,逗留时间,术中并发症,术后并发症,或转换。
结论：机器人手术可能在小儿胃肠道疾病的治疗中发挥作用。现代机器人平台上可用的数据有限，任何机器人平台和常规微创方法之间几乎没有比较数据。需要进一步的技术发展和研究，以增强我们对机器人技术在儿科手术领域的潜力的理解。
方法：根据PRISMA声明，在Pubmed，科克伦,还有Scopus.使用纽卡斯尔渥太华量表对研究进行了严格的评估。
结果：纳入了15项研究，其中7人患有先天性巨结肠病，8人患有其他适应症。纳入的研究在他们的人群中是异质的，年龄,和性,但所有机器人队列的术中并发症和转换发生率均较低.只有一项研究报告了一个比较队列，在机器人队列中手术时间更长(180与152和156分钟，p<0.001)，但在失血方面没有显著差异,逗留时间,术中并发症,术后并发症,或转换。
结论：机器人手术可能在小儿胃肠道疾病的治疗中发挥作用。现代机器人平台上可用的数据有限，任何机器人平台和常规微创方法之间几乎没有比较数据。需要进一步的技术发展和研究，以增强我们对机器人技术在儿科手术领域的潜力的理解。
