Ying Liyang,Liu Xiwang,Tan Zheng,et al.Application of Da Vinci robot assisted endoscopic technique in the treatment of patent ductus arteriosus in children[J].Journal of Clinical Pediatric Surgery,2021,20(12):1179-1182.[doi:10.12260/lcxewkzz.2021.12.015]
达芬奇机器人手术在儿童动脉导管未闭中的应用研究
- Title:
- Application of Da Vinci robot assisted endoscopic technique in the treatment of patent ductus arteriosus in children
- 关键词:
- 机器人; 腹腔镜; 动脉导管未闭/外科学; 儿童
- Keywords:
- Robotics; Laparoscopes; Ductus Arteriosus; Patent/SU; Child
- 分类号:
- R541.13;R726.1
- 摘要:
- 目的 评估达芬奇机器人手术治疗儿童动脉导管未闭的疗效与安全性。方法 回顾性分析浙江大学医学院附属儿童医院2020年8月至2021年4月共35例采用达芬奇机器人手术治疗的动脉导管未闭患者临床资料，收集患者年龄、体重、动脉导管直径、手术时间、术后住院时间、术后并发症及手术费用。术中采用右侧90°卧位，观察孔及两操作孔置于腋中线第五肋间、腋前线第四肋间及肩胛下线第六肋间，辅助孔置于腋前线第七肋间，术中均采用7号丝线双重或三道结扎动脉导管，术后撤除呼吸机后送普通病房。结果 35例均在机器人辅助下完成手术，无一例中转开胸手术；手术时间20~84 min，平均50.5 min；术中均无明显出血；术后住院时间1~6 d，平均1.8 d；术后动脉导管残余漏1例，喉返神经损伤致声音嘶哑1例，随访3个月后好转。平均住院费用5.4万，术后随访1~6个月无其他近期并发症。结论 达芬奇机器人手术治疗儿童动脉导管未闭创伤小，恢复快，是安全、有效及可靠的手术方式。
- Abstract:
- Objective To evaluate the efficacy and safety of Da Vinci robot assisted endoscopic technique in the treatment of patent ductus arteriosus (PDA) in children.Methods From August 2020 to March 2021, clinical data were retrospectively reviewed for 35 PDA children undergoing Da Vinci robot assisted endoscopy.Age, weight, diameter of ductus arteriosus, operative duration, postoperative hospital stay, postoperative complications and operative cost were recorded.During operations with right supine 90 degrees position, one observation hole and two operation holes were placed in Ⅴ intercostal space of axillary midline, Ⅳ intercostal space of axillary front line and Ⅵ intercostal space of subscapular line.And one auxiliary hole was placed in Ⅶ intercostal space of anterior axillary line.PDA was ligated by silk Ⅶ thread with double or three folds during operation.Then they were withdrawn from a ventilator and returned to general ward.Results All procedures were completed with the assistance of robot.There was no intraoperative conversion into thoracotomy.The average operative duration was 50.5(20-84) min.There was no obvious intraoperative hemorrhage.The average postoperative hospital stay was 1.8(1-6) days.There was one case of residual ductus arteriosus.And another case of recurrent laryngeal nerve injury improved after 3-month follow-ups.The average cost of hospitalization was 54, 000 yuan RMB.No other immediate complications occurred during a follow-up period of 1-6 months.Conclusion Da Vinci robotic surgery for pediatric PDA is safe, effective and reliable with minimal trauma, faster recovery and fewer surgical risks.
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备注/Memo
收稿日期:2021-04-19。
基金项目:浙江省自然科学基金（编号：LY20H150012）
通讯作者:舒强,Email:shuqiang@zju.edu.cn