Luo Mingshuang,Gao Heyun,Yi Yuexiong,et al.Efficacy comparison of conventional laparoscopy versus robot-assisted transumbilical single-incision laparoscopy for benign ovarian lesions in children and adolescents[J].Journal of Clinical Pediatric Surgery,,():567-571.[doi:10.3760/cma.j.cn101785-202310041-011]
Efficacy comparison of conventional laparoscopy versus robot-assisted transumbilical single-incision laparoscopy for benign ovarian lesions in children and adolescents
- Keywords:
- Benign Ovarian Lesions; Laparoscopy; Robotic Surgical Procedures; Surgical Procedures; Operative; Treatment Outcome; Child; Adolescent
- Abstract:
- Objective To preliminarily compare the surgical efficacies of generation IV Leonardo da Vinci robot-assisted single-incision laparoscopy versus traditional single-incision laparoscopy for benign ovarian lesions in children and adolescents.Methods From January 2018 to March 2023,the relevant clinical data were retrospectively reviewed for children and adolescents undergoing fourth generation IV Da Vinci robot-assisted single-hole laparoscopy (R-LESS,n=13) and traditional single-hole laparoscopy (LESS,n=22) for benign ovarian lesions.Operative duration,intraoperative volume of blood loss,ovarian torsion,ovarian tumor volume,intraoperative tumor rupture,placement of drainage tube,postoperative complication rate,postoperative hospitalization stay,hospitalization expense and follow-up time were recorded. Results As compared with LESS group,no significant inter-group differences existed in operative duration [161.38(103-201) vs.136.31(100.50-171.50) min],intraoperative volume of blood loss [21.15(10-32.50) vs.45.23(10-50) mL],incidence of ovarian torsion (15% vs.32%),intraoperative incidence of ovarian tumor rupture (23% vs.36%),placement of drainage tube (23% vs.23%),incidence of postoperative complications (8% vs. 6%) or follow-up time [20.70(11,29.5) vs.28.09(9.25,46.25) month].As compared with LESS group,length of postoperative hospitalization declined [4.23(3-5) vs.5.05(3.75-6.25) day] and hospitalization expense spiked [(40 557.01±4 036.29) vs. (26 456.32±6 413.30) yuan] in R-LESS group with statistical significance (P<0.05).Conclusions R-LESS is both safe and feasible for treating benign ovarian lesions in children and adolescents.As compared with LESS,R-LESS children recover more quickly post-operation.However,hospitalization expense is higher.Thus R-LESS is indicated for benign ovarian lesions in children and adolescents.In the future,large-scale comparative studies are still required for further verifications.
References:
[1] Al Jama FE,Al Ghamdi AA,Gasim T,et al.Ovarian tumors in children and adolescents:a clinical study of 52 patients in a university hospital[J].J Pediatr Adolesc Gynecol,2011,24(1):25-28.DOI:10.1016/j.jpag.2010.06.005.
[2] Litz C,Danielson PD,Chandler NM.Single incision laparoscopic surgery for pediatric adnexal pathology[J].J Pediatr Surg,2014,49(7):1156-1158.DOI:10.1016/j.jpedsurg.2013.10.017.
[3] 李治熹,蒋文军,曹李明,等.小儿卵巢肿瘤56例临床分析[J].临床小儿外科杂志,2016,15(5):485-487.DOI:10.3969/j.issn.1671-6353.2016.05.020. Li ZX,Jiang WJ,Cao LM,et al.Clinical features of ovarian tumor in children:a report of 56 cases[J].DOI:10.3969/j.issn.1671-6353.2016.05.020.
[4] Lawrence AE,Minneci PC,Deans KJ.Ovary-sparing surgery for benign pediatric ovarian masses[J].Curr Opin Pediatr,2019,31(3):386-390.DOI:10.1097/MOP.0000000000000776.
[5] Seckin B,Ozdener T,Tapisiz OL,et al.Laparoscopic treatment of ovarian cysts in adolescents and young adults[J].J Pediatr Adolesc Gynecol,2011,24(5):300-303.DOI:10.1016/j.jpag.2011.05.006.
[6] Pontarelli EM,Emami C,Nguyen NX,et al.Single-incision laparoscopic resection of ovarian masses in children:a preliminary report[J].Pediatr Surg Int,2013,29(7):715-718.DOI:10.1007/s00383-013-3325-5.
[7] Nakib G,Calcaterra V,Scorletti F,et al.Robotic assisted surgery in pediatric gynecology:promising innovation in mini invasive surgical procedures[J].J Pediatr Adolesc Gynecol,2013,26(1):e5-e7.DOI:10.1016/j.jpag.2012.09.009.
[8] Kuliha M,Roubec M,Procházka V,et al.Randomized clinical trial comparing neurological outcomes after carotid endarterectomy or stenting[J].Br J Surg,2015,102(3):194-201.DOI:10.1002/bjs.9677.
[9] 郭楠,倪观太,丁锦,等.经脐单孔腹腔镜卵巢囊肿手术[J].中国微创外科杂志,2019,19(6):515-517,522.DOI:10.3969/j.issn.1009-6604.2019.06.010. Guo N,Ni GT,Ding J,et al.Transumbilical laparoendoscopic single-port surgery for ovarian benign tumor[J].Chin J Minim Inva Surg,2019,19(6):515-517,522.DOI:10.3969/j.issn.1009-6604.2019.06.010.
[10] Nelson RJ,Chavali JSS,Yerram N,et al.Current status of robotic single-port surgery[J].Urol Ann,2017,9(3):217-222.DOI:10.4103/UA.UA_51_17.
[11] Escobar PF,Fader AN,Paraiso MF,et al.Robotic-assisted laparoendoscopic single-site surgery in gynecology:initial report and technique[J].J Minim Invasive Gynecol,2009,16(5):589-591.DOI:10.1016/j.jmig.2009.05.004.
[12] Xu DQ,Gao HY,Yu SZ,et al.Ensuring safety and feasibility for resection of pediatric benign ovarian tumors by single-port robot-assisted laparoscopic surgery using the da Vinci Xi system[J].Front Surg,2022,9:944662.DOI:10.3389/fsurg.2022.944662.
[13] 张文,李庚,骆明双.单孔机器人技术在儿童中的应用[J].临床外科杂志,2023,31(5):404-406.DOI:10.3969/j.issn.1005-6483.2023.05.002. Zhang W,Li G,Luo MS.Application of single-hole robot technology in children[J].J Clin Surg,2023,31(5):404-406.DOI:10.3969/j.issn.1005-6483.2023.05.002.
[14] Lopez S,Mulla ZD,Hernandez L,et al.A comparison of outcomes between robotic-assisted,single-site laparoscopy versus laparoendoscopic single site for benign hysterectomy[J].J Minim Invasive Gynecol,2016,23(1):84-88.DOI:10.1016/j.jmig.2015.08.883.
[15] 张书豪,高志刚,钭金法,等.机器人手术在小儿外科领域的应用现状[J].临床小儿外科杂志,2021,20(8):701-707.DOI:10.12260/lcxewkzz.2021.08.001. Zhang SH,Gao ZG,Tou JF,et al.Current applications of robotic procedures in pediatric surgery[J].J Clin Ped Sur,2021,20(8):701-707.DOI:10.12260/lcxewkzz.2021.08.001.
[16] Iavazzo C,Minis EE,Gkegkes ID.Single-site port robotic-assisted hysterectomy:an update[J].J Robot Surg,2018,12(2):201-213.DOI:10.1007/s11701-018-0789-2.
[17] Shim JI,Jo EH,Kim M,et al.A comparison of surgical outcomes between robot and laparoscopy-assisted adenomyomectomy[J].Medicine (Baltimore),2019,98(18):e15466.DOI:10.1097/MD.0000000000015466.
Memo
收稿日期:2023-10-19。
基金项目:武汉大学中南医院学科建设项目(YYXKNLJS2024020)
通信作者:张文,Email:wzhang115@163.com