Jin Yi,Chen Qingjiang,Zhang Yuebin,et al.Comparative study of Da Vinci technique versus traditional laparoscopy in the treatment of intestinal duplication[J].Journal of Clinical Pediatric Surgery,,21():632-636.[doi:10.3760/cma.j.cn101785-202204005-007]
Comparative study of Da Vinci technique versus traditional laparoscopy in the treatment of intestinal duplication
- Keywords:
- Digestive System Abnormalities/SU; Intestines/SU; Mini-Invasive Surgical Procedures; Robotic Surgical Procedures; Laparoscopy
- Abstract:
- Objective To compare the application outcomes of Da Vinci robot versus traditional laparoscope in the resection of intestinal duplication in children.Methods Between April 2020 and December 2021, retrospective review was conducted for 44 children of intestinal duplication undergoing surgery.They were divided into two groups of robot surgery (n=14) and laparoscopic-assisted surgery (n=30).The relevant clinical data of operative duration, postoperative fasting time, postoperative hospital stay and hospitalization expenses were compared between two groups.Results The operative durations of robot surgery and laparoscopic-assisted surgery groups were[(85.57±18.88) vs.(84.33±19.82) min].There was no significant inter-group statistical difference (t=0.196, P=0.846).Intestinal duplication was completely peeled off by endoscope in robot surgery group, intestinal integrity was preserved and intestinal resection and anastomosis were not required.Postoperative fasting time was 3 (2, 3.25) versus 4 (4, 5) days and the difference was statistically significant (Z=-3.493, P=<0.001).The postoperative length of hospital stay was 6(4.75, 6.25) days in robot operation group and 7.5(6, 10) days in laparoscopic-assisted operation group (Z=-3.679, P<0.001).And hospitalization expenses was 64000 yuan in Da Vinci operation group and 17000 yuan in laparoscopic-assisted operation group (Z=-5.292, P<0.001).Conclusion Da Vinci robot resection of intestinal duplication is both safe and feasible in children.Its preciseness is much better than that of conventional laparoscopy so that patients may recover faster after operation.
References:
[1] Sangüesa Nebot C, Llorens Salvador R, Carazo Palacios E, et al.Enteric duplication cysts in children:varied presentations, varied imaging findings[J].Insights Imaging, 2018, 9(6):1097-1106.DOI:10.1007/s13244-018-0660-z.
[2] Erginel B, Soysal FG, Ozbey H, et al.Enteric duplication cysts in children:a single-institution series with forty patients in twenty-six years[J].World J Surg, 2017, 41(2):620-624.DOI:10.1007/s00268-016-3742-4.
[3] Schleef J, Schalamon J.The role of laparoscopy in the diagnosis and treatment of intestinal duplication in childhood.A report of two cases[J].Surg Endosc, 2000, 14(9):865.DOI:10.1007/s004640000123.
[4] Górecki W, Bogusz B, Zaj?c A, et al.Laparoscopic and laparoscopy-assisted resection of enteric duplication cysts in children[J].J Laparoendosc Adv Surg Tech A, 2015, 25(10):838-840.DOI:10.1089/lap.2015.0103.
[5] Autorino R, Zargar H, Kaouk JH.Robotic-assisted laparoscopic surgery:recent advances in urology[J].Fertil Steril, 2014, 102(4):939-949.DOI:10.1016/j.fertnstert.2014.05.033.
[6] 汤绍涛.机器人手术在小儿外科中的发展现状及展望[J].机器人外科学杂志(中英文), 2021, 2(4):241-247.DOI:10.12180/j.issn.2096-7721.2021.04.001.Tang ST.Robot-assisted surgery in children:current status and future prospects[J].Chinese Journal of Robotic Surgery, 2021, 2(4):241-247.DOI:10.12180/j.issn.2096-7721.2021.04.001.
[7] 黄格元, 蓝传亮, 刘雪来, 等.达芬奇机器人在小儿外科手术中的应用(附20例报告)[J].中国微创外科杂志, 2013, 13(1):4-8.DOI:10.3969/j.issn.1009-6604.2013.01.002.Wang GY, Lan CL, Liu XL, et al.Da vinci robotic system for pediatric surgery:report of first 20 cases[J].Chin J Min Inv Surg, 2013, 13(1):4-8.DOI:10.3969/j.issn.1009-6604.2013.01.002.
[8] Najarian S, Fallahnezhad M, Afshari E.Advances in medical robotic systems with specific applications in surgery-a review[J].J Med Eng Technol, 2011, 35(1):19-33.DOI:10.3109/03091902.2010.535593.
[9] Kim SH, Cho YH, Kim HY.Alimentary tract duplication in pediatric patients:its distinct clinical features and managements[J].Pediatr Gastroenterol Hepatol Nutr, 2020, 23(5):423-429.DOI:10.5223/pghn.2020.23.5.423.
[10] 梅董昱, 严志龙, 陈盛.腹腔镜下儿童肠重复畸形的外科治疗[J].临床小儿外科杂志, 2017, 16(6):569-573.DOI:10.3969/j.issn.1671-6353.2017.06.010.Mei DY, Yan ZL, Chen S.Laparoscopy in the management of pediatric intestinal duplication[J].J Clin Ped Sur, 2017, 16(6):569-573.DOI:10.3969/j.issn.1671-6353.2017.06.010.
[11] 蔡多特, 陈青江, 章立峰, 等.达芬奇技术与传统腹腔镜技术在胆总管囊肿根治术中应用的对比研究[J].临床小儿外科杂志, 2022, 21(1):51-57.DOI:10.3760/cma.j.cn.101785-202012066-010.Cai DT, Chen QJ, Zhang LF, et al.Comparative study of Da Vinci technique versus traditional laparoscopy in the treatment of choledochal cyst[J].J Clin Ped Sur, 2022, 21(1):51-57.DOI:10.3760/cma.j.cn.101785-202012066-010.
Memo
收稿日期:2022-04-02。
基金项目:浙江省卫生健康科技计划(2022RC201)
通讯作者:高志刚,Email:ebwk@zju.edu.cn