Tao Boyuan,Zhong Zhizu,Zeng Jixiao,et al.Efficacy and safety of robotic assisted surgery versus conventional laparoscopy for pediatric choledochal cyst[J].Journal of Clinical Pediatric Surgery,,():214-219.[doi:10.3760/cma.j.cn101785-20251226-00131]
Efficacy and safety of robotic assisted surgery versus conventional laparoscopy for pediatric choledochal cyst
- Keywords:
- Choledochal Cyst; Laparoscopy; Surgical Procedures; Operative; Robotic Surgical Procedures; Child
- Abstract:
- Objective To compare clinical efficacy between da Vinci robot assisted hepaticojejunostomy (RAH) versus conventional four-port laparoscopic hepaticojejunostomy (CLH) for pediatric choledochal cyst.Methods From January 2020 to June 2025,133 children with choledochal cyst were hospitalized.According to the inclusion criteria,the relevant clinical data were retrospectively examined.RAH (n=49) and CLH (n=83) were performed.Baseline profiles,intraoperative findings and curative effect were compared between two groups.Results No statistically significant inter-group differences existed in age,weight and cyst type (P>0.05).As compared to traditional group,da Vinci robotic group showed significantly shorter total operative duration (T1)[(197.8±43.0) vs. (178.9±41.0) min,P=0.014],cyst dissection and biliary reconstruction time (T2)[(137.2±28.7) vs. (126.8±26.7) min,P=0.040],duration of drainage tube retention[80.0(72.5,90.9) vs. 66.1(58.3,88.9) h,P=0.035]and intestinal function recovery time[(16.5±5.3) vs.(14.2±5.6) h,P=0.023].Intraoperative blood loss was significantly lesser in da Vinci robotic group than that in traditional group with a significant difference[(6.0±1.4) vs. (5.2±1.8) mL,P=0.012].While pain scores at6hours after analgesic pump removal[(2.6±0.7) vs. (2.9±0.5) points,P=0.016]and hospitalization expenses[(44 830.0±7595.0) vs. (76 653.1±5 743.3) yuan,P<0.001]were significantly higher.Incision satisfaction score was significantly lower in da Vinci robotic group than that in traditional group[(8.8±0.6) vs. (8.4±0.8) points,P=0.024].There were significant inter-group differences.No statistically significant intergroup differences existed in biliary-enteric anastomosis diameter,drainage tube retention rate,postoperative hospitalization stay,follow-up length or short- to medium-term complication rates (P>0.05).Conclusions With its flexible operability and precision,robot assisted surgery significantly may reduce surgical difficulty during cyst separation and hepaticojejunostomy.As compared with CLH,RAH facilitates faster postoperative recovery and it has demonstrated comparable short-and medium-term complication rates.However,its limitations include larger Trocar incisions,more noticeable postoperative scarring and higher expenses.
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Memo
收稿日期:2025-12-26。
基金项目:广州地区临床特色技术项目(2026P-TS015);广州市卫生健康科技一般引导项目(20261A011022)
通讯作者:曾纪晓,Email:zengjixiao@163.com