Li Wei,Luo Jingchu,Hu Hai,et al.Clinical efficacy of enhanced recovery after surgery plus robot-assisted laparoscopy for congenital biliary dilatation in children[J].Journal of Clinical Pediatric Surgery,,():758-763.[doi:10.3760/cma.j.cn101785-202402027-010]
Clinical efficacy of enhanced recovery after surgery plus robot-assisted laparoscopy for congenital biliary dilatation in children
- Keywords:
- Robot; Enhanced Recovery After Surgery; Congenital Biliary Dilatation; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the efficacies of combining perioperative measures of enhanced recovery after surgery (ERAS) with robot-assisted laparoscopy in children with congenital biliary dilatation (CBD). Methods Between January 2015 and December 2021,retrospective analysis was performed for the relevant clinical data of 81 hospitalized CBD children.They were categorized into three groups based upon specific treatment options.Group A underwent traditional perioperative management with conventional laparoscopy (n=26),group B (n=26) ERAS management during perioperative period with conventional laparoscopy while group C (n=29) ERAS management during perioperative period with robot-assisted laparoscopy.Operative durations,postoperative inflammatory parameters,postoperative pain scores,postoperative hospitalization stay and postoperative complication rates were compared among three groups. Results Operative durations of groups A,B and C were (239.3±32.6),(234.8±29.3) and (195.7±38.6) min.At Day 1 post-operation,C-reactive protein (CRP) level was (18.0±4.3),(16.7±4.5) and (14.5±3.3) mg/L.Postoperative time to initial feeding was (58.9±6.1),(27.4±2.7) and (28.7±2.4) hour while postoperative time to stop fluid supplementation was (7.7±0.9),(6.4±0.5) and (6.0±0.6) day.Length of postoperative hospital stay was (9.7±1.0),(7.7±0.8) and (6.8±0.8) day.Significant differences existed among three groups (P<0.05).At Day 1 post-operation,pain scores of groups A,B and C were (3.1±0.7),(2.6±0.4) and (2.5±0.5).At Day 2 post-operation,scores were (2.8±0.8),(2.2±0.5) and (2.1±0.4) with statistically significant differences among three groups (P<0.05).In group A,there were bile leakage with hemorrhage (n=1),upper respiratory tract (URT) infection (n=1) and unplanned reoperation (n=1);In group B,bile leakage (n=1) and unplanned reoperation (n=1);In group C,intestinal obstruction (n=1) and URT infection (n=1).No statistically significant differences in postoperative complications existed among three groups (P>0.05). Conclusions For CBD children,combining ERAS measures with robot-assisted laparoscopy offers the advantages of shortening operative duration,lowering surgical stresses,alleviating pain and promoting postoperative recovery.The above goals may be achieved after mastering the robotic surgical skills.
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Memo
收稿日期:2024-2-27。
基金项目:广西医疗卫生适宜技术开发与推广应用项目(S2022068)
通讯作者:罗意革,Email:lyg6829@163.com