Xuan Xiaoxiao,Luo Wenjuan,Huang Zongwei,et al.Efficacy of robot-assisted laparoscopic partial splenectomy for benign splenic lesions in children[J].Journal of Clinical Pediatric Surgery,,():263-267.[doi:10.3760/cma.j.cn101785-202412068]
Efficacy of robot-assisted laparoscopic partial splenectomy for benign splenic lesions in children
- Keywords:
- Splenectomy; Splenic Diseases; Laparoscopy; Robotic Surgery; Child
- Abstract:
- Objective To evaluate the safety and clinical efficacy of robot-assisted laparoscopic partial splenectomy in the treatment of benign splenic lesions in children.Methods This retrospective cohort study analyzed the clinical data of 23 children with benign splenic lesions who underwent laparoscopic or robot-assisted laparoscopic partial splenectomy at the Childrens Hospital,Zhejiang University School of Medicine between June 2015 and July 2024.Surgical outcomes and postoperative prognosis were compared between the two groups.Results Among the 23 patients,12 were male and 11 were female,with a median age of 10.50 (8.00,12.08) years.Two patients presented with intermittent abdominal pain,and four had splenic cysts complicated by infection,including one patient who underwent external cyst drainage followed by delayed partial splenectomy.The maximum diameter of the lesions was 5.85 (5.30,8.00) cm.Nine lesions were located at the upper pole or upper-middle portion of the spleen,and fourteen at the lower pole or lower-middle portion.All procedures were completed successfully without conversion to open surgery.Five patients underwent laparoscopic partial splenectomy and eighteen underwent robot-assisted laparoscopic partial splenectomy.In the robotic surgery group,three patients underwent super-selective splenic vessel ligation due to lesions extending across the upper and lower poles of the spleen,and three patients with giant lesions underwent subtotal splenectomy by transection of the main splenic artery while preserving the short gastric vessels and the splenophrenic ligament.Compared with the laparoscopic group,the robotic group showed significantly shorter operative time[185.00 (167.00,198.50) min vs. 147.00 (111.50,172.25) min]and less intraoperative blood loss[50.00 (35.00,50.00) mL vs. 20.00 (13.75,31.25) mL](P<0.05).There was no significant difference in postoperative hospital stay between the two groups[11.00 (10.50,13.00) d vs.9.00 (7.00,11.00) d](P>0.05).Postoperative pathological examination revealed splenic cysts in 10 cases,lymphangiomas in 6 cases,splenic hamartomas in 4 cases,and one case each of splenic hemangioma,sclerosing angiomatoid nodular transformation and littoral cell angioma.No postoperative complications such as bleeding,residual splenic ischemia,intra-abdominal infection,intestinal adhesion,or overwhelming infection were observed.The mean follow-up period was 23.4 months,during which no recurrence was detected.Ultrasonography indicated a trend of increasing residual splenic volume.Conclusions Partial splenectomy is a safe and reliable treatment for benign splenic lesions in children.Robot-assisted laparoscopic partial splenectomy can significantly shorten operative time and reduce intraoperative blood loss,making it a preferable surgical approach for pediatric partial splenectomy.
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Memo
收稿日期:2024-12-31。
基金项目:浙江省自然科学基金(LY20H030007)
通讯作者:陈青江,Email:chenqj0157@zju.edu.cn