■本研究的目的是比较经脐单部位加一个机器人辅助手术和经脐单部位腹腔镜手术治疗胆总管囊肿的术中和术后结果。
■我们回顾性分析了在2020年6月至2023年12月期间入院的49例诊断为胆总管囊肿的儿童的临床数据。在这些患者中,24例接受了经脐单部位加一达芬奇机器人辅助手术(机器人组),25例接受了经脐单部位腹腔镜辅助手术(腹腔镜组)。我们比较了两组术中和术后结局的差异。
■两组患者在性别方面没有显着差异,年龄,体重,临床症状,囊肿最大直径,type,术后并发症,和面部表情,腿部运动,活动,哭泣,舒适度(FLACC)评分(p>0.05)。与腹腔镜组患者相比,机器人组的术中出血较少[10(8-12)与15(11.5-18)ml,p<0.001,术后引流管留置时间少[5(4-6)vs.7(5.5-8)天,p<0.001],术后禁食时间少[4(3-4)vs.6(5-7)天,p<0.001],术后住院时间少[6(6-7)vs.8(6-10)天,p<0.001],但他们需要更多的手术时间[385.5(317.0-413.3)与346.0(287.0-376.5)分钟,p=0.050]并消耗更多的住院费用(79,323±3,124vs.31,121±2,918元,p<0.001)。
■这项研究的结果表明,住院时间较短,术后恢复更快,对于选择机器人手术而不是腹腔镜手术的患者,组织损伤较小,但成本较高,手术时间较长。随着安装机器人辅助手术系统规模的不断扩大和外科医生技术经验的逐步积累,机器人辅助手术可能会慢慢超越,并显示出替代的趋势,腹腔镜检查因其优点。
UNASSIGNED: The purpose of this study is to compare the intraoperative and postoperative outcomes of a trans-umbilical single-site plus one robot-assisted surgery and a trans-umbilical single-site laparoscopic surgery in the treatment of choledochal cysts.
UNASSIGNED: We retrospectively analyzed clinical data from 49 children diagnosed with choledochal cysts who were admitted to our hospital between June 2020 and December 2023. Among these patients, 24 underwent a trans-umbilical single-site plus one Da Vinci robot-assisted surgery (the robot group) and 25 underwent a trans-umbilical single-site laparoscopic-assisted surgery (the laparoscopic group). We compared differences in intraoperative and postoperative outcomes between the two groups.
UNASSIGNED: There was no significant difference between the two groups of patients in terms of gender, age, weight, clinical symptoms, maximum cyst diameter, type, postoperative complications, and facial expression, leg movement, activity, crying, and comfortability (FLACC) scoring (p > 0.05). Compared with the patients in the laparoscopic group, those in the robot group had less intraoperative bleeding [10 (8-12) vs. 15 (11.5-18) ml, p < 0.001] and required less postoperative drainage tube indwelling time [5 (4-6) vs. 7 (5.5-8) day, p < 0.001], less postoperative fasting time [4 (3-4) vs. 6 (5-7) days, p < 0.001], and less postoperative hospitalization time [6 (6-7) vs. 8 (6-10) days, p < 0.001], but they required more operative time [385.5 (317.0-413.3) vs. 346.0 (287.0-376.5) min, p = 0.050] and consumed more hospitalization expenses (79,323 ± 3,124 vs. 31,121 ± 2,918 yuan, p < 0.001).
UNASSIGNED: The results of this study showed a shorter hospitalization time, quicker postoperative recovery, and less tissue damage but a higher cost and a longer operation time in patients who chose robotic surgery rather than laparoscopic surgery. With the continuous expansion of the scale of installed robot-assisted surgical systems and the gradual accumulation of the technical experience of surgeons, robot-assisted surgery may slowly surpass, and shows a trend to replace, laparoscopy because of its advantages.