Zhang Yuebin,Chen Qingjiang,Cai Duote,et al.Robot-assisted laparoscopic splenectomy in children: a report of 3 cases with review of the literature[J].Journal of Clinical Pediatric Surgery,2021,20(08):718-723.[doi:10.12260/lcxewkzz.2021.08.004]
机器人手术系统辅助儿童脾切除术三例并文献复习
- Title:
- Robot-assisted laparoscopic splenectomy in children: a report of 3 cases with review of the literature
- Keywords:
- Robotic Surgical Procedures; Laparoscopy; Splenectomy; Child
- 分类号:
- R733.2;R726.1
- 摘要:
- 目的 探讨机器人手术系统在儿童脾切除和脾部分切除手术中应用的安全性和可行性。方法 回顾性分析2020年4月至2020年10月在浙江大学医学院附属儿童医院接受机器人系统辅助腹腔镜技术行脾切除或脾部分切除的3例脾脏肿物患者临床资料。3例手术由同一术者完成，分析患者术前病历资料、手术处理过程、术后并发症及术后恢复情况。结果 3例脾脏肿物患者均顺利完成机器人辅助腹腔镜下脾切除术或部分切除术，无中转开腹病例，近期随访无术后并发症发生。手术时间102~185 min，机器人手术系统装机时间12~15 min，术中出血量2~50 mL，术后住院时间11~13 d。结论 机器人手术系统应用于儿童脾切除术和脾部分切除术是安全可行的。
- Abstract:
- Objective To explore the safety and feasibility of Da Vinci XI robotic surgical system during splenectomy and partial splenectomy in children. Methods A retrospective study was conducted for 3 children with splenic tumor undergoing Duvenchi XI robotic system assisted splenectomy or partial splenectomy from April 2020 to October 2020. All procedures were performed by a same surgeon. Preoperative profiles, surgical handling, postoperative complications and postoperative recovery were analyzed. Results Successful splenectomy or partial splenectomy was performed and no case was converted into open surgery. No postoperative complications occurred during recent follow-ups. The operative duration was 102 to 185 min, the installation of Da Vinci XI system took 12 to 15 min, the volume of intraoperative blood loss was 2 to 50 ml and the postoperative hospital stay 11 to 13 days. Conclusion Da Vinci XI robotic surgical system is both safe and feasible for splenectomy and partial splenectomy in children.
参考文献/References:
1 Wilson EB.The evolution of robotic general surgery[J]. Scand J Surg, 2009, 98(2):125-134. DOI:10.1177/145749690909800208.
2 Denning NL, Kallis MP, Prince JM.Pediatric Robotic Surgery[J]. Surg Clin North Am, 2020, 100(2):431-443. DOI:10.1016/j.suc.2019.12.004.
3 Mizuno K, Kojima Y, Nishio H, et al. Robotic surgery in pediatric urology:Current status[J]. Asian J Endosc Surg, 2018, 11(4):308-317. DOI:10.1111/ases.12653.
4 Sheth KR, Koh CJ.The Future of Robotic Surgery in Pediatric Urology:Upcoming Technology and Evolution Within the Field[J]. Front Pediatr, 2019, 7:259. DOI:10.3389/fped.2019.00259.
5 Venkatakarthikeyan C, Nair S, Gowrishankar M, et al. Robotic Surgery in Head and Neck in Pediatric Population:Our Experience[J]. Indian J Otolaryngol Head Neck Surg, 2020, 72(1):98-103. DOI:10.1007/s12070-019-01768-x.
6 Meignan P, Ballouhey Q, Lejeune J, et al. Robotic-assisted laparoscopic surgery for pediatric tumors:a bicenter experience[J]. J Robot Surg, 2018, 12(3):501-508. DOI:10.1007/s11701-017-0773-2.
7 Mbaka MI, Robl E, Camps JI.Laparoscopic versus robotic-assisted splenectomy in the pediatric population:our institutional experience[J]. Am Surg, 2017, 83(9):e358-e359. DOI:10.1177/000313481708300906.
8 Delaitre B, Maignien B.Splenectomy by the laparoscopic approach.Report of a case[J]. Presse Medicale, 1991, 20(44):2263. DOI:10.1016/0191-2607(84)90147-X.
9 Tulman S, Holcomb GW 3rd, Karamanoukian HL, et al. Pediatric laparoscopic splenectomy[J]. J Pediatr Surg, 1993, 28(5):689-692. DOI:10.1016/0022-3468(93)90033-h.
10 Talamini MA, Chapman S, Horgan S, et al. A prospective analysis of 211 robotic-assisted surgical procedures[J]. Surgical Endoscopy and Other Interventional Techniques, 2003, 17(10):1521-1524. DOI:10.1007/s00464-002-8853-3.
11 阮虎, 江志伟, 赵坤, 等. 达芬奇机器人系统在脾切除术中的应用[J]. 腹腔镜外科杂志, 2013, 18(12):899-901. DOI:10.13499/j.cnki.fqjwkzz.2013.12.008. Ruan H, Jiang ZW, Zhao K, et al. Robot-assisted splenectomy[J]. Journal of Laparoscopic Surgery, 2013, 18(12):899-901. DOI:10.13499/j.cnki.fqjwkzz.2013.12.008.
12 Shelby R, Kulaylat AN, Villella A, et al. A comparison of robotic-assisted splenectomy and laparoscopic splenectomy for children with hematologic disorders[J]. J Pediatr Surg, 2020, 8:S0022-3468(20)30615-1. DOI:10.1016/j.jpedsurg.2020.08.031.
13 Shah CA, Beck T, Liao JB, et al. Surgical and oncologic outcomes after robotic radical hysterectomy as compared to open radical hysterectomy in the treatment of early cervical cancer[J]. J Gynecol Oncol, 2017, 28(6):e82. DOI:10.3802/jgo.2017.28.e82.
14 Giza DE, Tudor S, Purnichescu-Purtan RR, et al. Robotic splenectomy:what is the real benefit?[J]. World J Surg, 2014, 38(12):3067-3073. DOI:10.1007/s00268-014-2697-6.
15 Fachin CG, Amado F, Romaniello G, et al. Open versus laparoscopic splenectomies in children:a comparative study performed at a public hospital in Brazil[J]. J Laparoendosc Adv Surg Tech A, 2019, 29(10):1357-1361. DOI:10.1089/lap.2019.0123.
16 Utria AF, Goffredo P, Keck K, et al. Laparoscopic Splenectomy:Has It Become the Standard Surgical Approach in Pediatric Patients?[J]. J Surg Res, 2019, 240:109-114. DOI:10.1016/j.jss.0219.02.045.
17 Qureshi FG, Ergun O, Sandulache VC, et al. Laparoscopic splenectomy in children[J]. JSLS, 2005, 9(4):389-392. DOI:10.1007/BF00190159.
18 Alwabari A, Parida L, Al-Salem AH.Laparoscopic splenectomy and/or cholecystectomy for children with sickle cell disease[J]. Pediatr Surg Int, 2009, 25(5):417-421. DOI:10.1007/s00383-009-2352-8.
19 Rescorla FJ, Breitfeld PP, West KW, et al. A case controlled comparison of open and laparoscopic splenectomy in children[J]. Surgery, 1998, 124(4):670-676. DOI:10.1067/msy.1998.91223.
20 Hassan ME, Al Ali K.Massive splenomegaly in children:laparoscopic versus open splenectomy[J]. JSLS, 2014, 18(3):e2014.00245. DOI:10.4293/JSLS.2014.00245.
21 Goers T, Panepinto J, Debaun M, et al. Laparoscopic versus open abdominal surgery in children with sickle cell disease is associated with a shorter hospital stay[J]. Pediatr Blood Cancer, 2008, 50(3):603-606. DOI:10.1002/pbc.21245.
22 Farah RA, Rogers ZR, Thompson WR, et al. Comparison of laparoscopic and open splenectomy in children with hematologic disorders[J]. J Pediatr, 1997, 131:41-46. DOI:10.1016/s0022-3476(97)70122-7.
23 徐冰, 彭兵, 曹李明, 等. 儿童腹腔镜脾切除术35例分析[J]. 临床小儿外科杂志, 2013, 12(3):216-218. DOI:10.3969/j.issn.1671-6353.2013.03.016. Xu B, Peng B, Cao LM, et al. Laparoscopic splenectomy in children:a report of 35 cases[J]. J Clin Ped Sur, 2013, 12(3):216-218. DOI:10.3969/j.issn.1671-6353.2013.03.016.
24 席红卫, 崔强强, 王建峰, 等. 分级脾蒂结扎法在儿童腹腔镜脾切除术中的应用[J]. 临床小儿外科杂志, 2010, 9(3):184-185. DOI:10.3969/j.issn.1671-6353.2010.03.011. Xi HW, Cui QQ, Wang JF, et al. Application of fractional ligature of splenic stalk during laparoscopic splenectomy in children[J]. J Clin Ped Sur, 2010, 9(3) 184-185. DOI:10.3969/j.issn.671-6353.2010.03.011.
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备注/Memo
收稿日期:2021-02-26。
基金项目:国家重点研发计划（编号：2018YFC1002700）；浙江省医药卫生科技计划项目（编号：2017KY434）
通讯作者:高志刚,Email:ebwk@zju.edu.cn