[1]曹华林,廖松柏,陈小叶,等.腹腔镜与机器人辅助腹腔镜Lich-Gregoir输尿管膀胱再植术的对比研究[J].临床小儿外科杂志,2025,(06):519-524.[doi:10.3760/cma.j.cn101785-202502019-004]
　Cao Hualin,Liao Songbai,Chen Xiaoye,et al.Comparison between laparoscopic and robot-assisted laparoscopic Lich-Gregoir ureteral reimplantation[J].Journal of Clinical Pediatric Surgery,2025,(06):519-524.[doi:10.3760/cma.j.cn101785-202502019-004]
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腹腔镜与机器人辅助腹腔镜Lich-Gregoir输尿管膀胱再植术的对比研究

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 期数: 2025年06 页码: 519-524 栏目: 专题·机器人手术系统在小儿外科的应用 出版日期: 2025-06-28
Title:
Comparison between laparoscopic and robot-assisted laparoscopic Lich-Gregoir ureteral reimplantation
作者:
曹华林1;  廖松柏1;  陈小叶1;  姜心诚2;  叶惟靖2;  易小钰3;  卓然3;  李品3;  周辉霞3
1. 广西壮族自治区南溪山医院 广西壮族自治区第二人民医院泌尿外科, 桂林 541002;
2. 上海交通大学医学院附属仁济医院浦南分院泌尿外科, 上海 200120;
3. 解放军总医院第七医学中心儿科医学部儿童泌尿外科, 北京 100700
Author(s):
Cao Hualin1;  Liao Songbai1;  Chen Xiaoye1;  Jiang Xincheng2;  Ye Weijing2;  Yi Xiaoyu3;  Zhuo Ran3;  Li Pin3;  Zhou Huixia3
1. Department of Urology, Nanxi Shan Hospital of Guangxi Zhuang Autonomous Region (Second People’s Hospital of Guangxi Zhuang Autonomous Region), Guilin 541002, China;
2. Department of Urology, Punan Campus, Affiliated Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai 200120, China;
3. Department of Pediatric Urology, Division of Pediatrics, Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China
关键词:
原发性梗阻性巨输尿管; 原发性膀胱输尿反流; 腹腔镜手术; 机器人手术; 泌尿外科手术; 治疗结果; 儿童; 对比研究
Keywords:
Primary Obstructive Megaureter; Vesicoureteral Reflux; Laparoscopy Surgery; Robotic Surgical Procedures; Urologic Surgical Procedures; Treatment Outcome; Child; Comparative Study
DOI:
10.3760/cma.j.cn101785-202502019-004
摘要:
目的 比较腹腔镜Lich-Gregoir输尿管膀胱再植术(laparoscopic ureteral reimplantation,LUR)与机器人辅助腹腔镜Lich-Gregoir输尿管膀胱再植术(robot-assisted laparoscopic ureteral reimplantation,RALUR)治疗儿童原发性梗阻性巨输尿管(primary obstructive megaureter,POM)和膀胱输尿管反流(vesicoureteral reflux,VUR)的临床疗效。方法 回顾性分析2019年5月至2023年12月广西壮族自治区南溪山医院、上海交通大学医学院附属仁济医院浦南分院、解放军总医院第七医学中心儿科医学部应用LUR与RALUR治疗的52例POM和VUR患儿临床资料。按照不同手术方式分为LUR组(21例)和RALUR组(31例)。比较两组患儿基线数据、手术时间、术中出血量、引流管留置时间、术后住院时间、住院总费用、术者与助手舒适度评分、术后并发症发生率及手术成功率方面的差异。结果 52例均顺利完成手术,无一例中转开放手术,术中无一例严重并发症发生。两组患儿年龄(P=0.337)、性别(P=0.971)、患病侧别(P=0.778)和病因诊断(P=0.695)方面比较,差异均无统计学意义。手术时间:RALUR组为(109.5±11.3)min,较LUR组的(149.5±19.3)min短,差异有统计学意义(P＜0.001);术者舒适度评分:RALUR组为(7.3±0.9)分,较LUR组的(4.5±1.1)分高,差异有统计学意义(P＜0.001);助手舒适度评分:RALUR组为(7.9±0.7)分,较LUR组的(3.7±0.6)分高,差异有统计学意义(P＜0.001);住院总费用:RALUR组为(7.1±0.6)万元,较LUR组的(3.1±0.4)万元高,差异有统计学意义(P＜0.001)。LUR组与RALUR组在术中出血量[10(10.0,15.0)mL比10(10.0,15.0)mL,P=0.532]、引流管留置时间[(4.7±0.7) d比(4.5±0.6)d,P=0.239]、术后住院时间[(6.3±1.6)d比(6.3±1.0) d,P=0.977]、术后并发症发生率(33.3%比29.0%,P=0.742)和手术成功率(100%比100%,P=1.000)方面比较,差异均无统计学意义(P＞0.05)。结论 LUR与RALUR均是治疗儿童POM和VUR安全、有效的方法;与LUR相比,RALUR具有手术时间更短、术者与助手舒适度更高等优点。
Abstract:
Objective To compare the clinical efficacy of laparoscopic ureteral reimplantation (LUR) versus robot-assisted laparoscopic ureteral reimplantation (RALUR) for primary obstructive megaureter (POM) and vesicoureteral reflux (VUR) in children. Methods The relevant clinical data were retrospectively reviewed for 52 POM/VUR children undergoing LUR and RALUR between May 2019 and December 2023.Based upon surgical techniques,they were assigned into two groups of LUR (n=21) and RALUR (n=31).Comparative analysis was conducted for assessing inter-group discrepancies in baseline profiles,operative duration,intraoperative volume of blood loss,duration of drainage tubing,length of postoperative hospitalization stay,total hospitalization expense,comfort scores of operators and assistants,postoperative complication rates and surgical success outcomes. Results All surgeries were successfully completed without any conversion into open surgery or serious intraoperative complication.No statistically significant inter-group differences existed in age (P=0.337),gender (P=0.971),affected sideness (P=0.778) and etiological diagnosis (P=0.695).Operative duration was significantly shorter in RALUR group than (compared to LUR group[(109.5±11.3) vs. (149.5±19.3),P<0.001] Operator comfort scores were significantly higher in RALUR group than that in LUR group[(7.3±0.9) vs. (4.5±1.1),P<0.001] .Assistant comfort score was significantly higher in RALUR group than that in LUR group[(7.9±0.7) vs. (3.7±0.6),P<0.001] .Total hospitalization expense was significantly higher in RALUR group than that in LUR group [(7.1±0.6)×104 vs. (3.1±0.4)×104 yuan,P<0.001].No statistically significant inter-group differences existed in intraoperative volume of blood loss [10(10.0,15.0) vs. 10(10.0,15.0) mL,P=0.532),drainage tubing time [(4.7±0.7) vs. (4.5±0.6) day,P=0.239],duration of postoperative hospitalization stay [(6.3±1.6) vs. (6.3±1.0) day,P=0.977],rates of postoperative complications (33.3% vs. 29.0%,P=0.742) and success rate (100% vs. 100%,P=1.000). Conclusions LUR and RALUR are both safe and effective in managing POM and VUR in children.And RALUR offers the advantages of shorter surgical duration and greater comfort for operator and assistant as compared to LUR.

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备注/Memo

收稿日期:2025-2-10。
基金项目:广西自然科学基金(2025GXNSFBA069059);首府地区公立医院高水平临床专科建设示范工程(NM202401)
通讯作者:周辉霞,Email:huixia99999@163.com

更新日期/Last Update: 2025-06-28