Tang Yinbing,Gao Zhigang,Xiong Jieni,et al.Safety and feasibility of laparoscopic and robotic-assisted day-surgery resection for benign ovarian tumors in children[J].Journal of Clinical Pediatric Surgery,2025,(06):532-541.[doi:10.3760/cma.j.cn101785-202504023-006]
日间手术模式下儿童卵巢良性肿瘤腹腔镜及机器人手术的安全性和可行性研究
- Title:
- Safety and feasibility of laparoscopic and robotic-assisted day-surgery resection for benign ovarian tumors in children
- Keywords:
- Ovarian Tumors; Child; Day Surgery; Minimally Invasive Surgery; Laparoscopic Surgery; Robotic Surgical Procedures; Comparative Study
- 摘要:
- 目的 探讨日间手术模式下开展腹腔镜及机器人辅助下儿童卵巢良性肿瘤手术的安全性和可行性。方法 回顾性分析2020年1月至2024年12月浙江大学医学院附属儿童医院完成的327例卵巢良性肿瘤微创切除病例临床资料,根据手术方式分为腹腔镜手术组(n=296)和机器人手术组(n=31),比较两种手术方式在日间手术模式和非日间手术模式下患儿一般资料、住院时间、住院费用、手术时间和术后并发症等方面的差异。结果 327例患儿均顺利完成卵巢肿瘤微创切除术。无论是腹腔镜手术组还是机器人手术组,日间手术模式和非日间手术模式在患儿年龄、地域、肿瘤单双侧占比、肿瘤长径、美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级、手术时间、术中出血量、引流管留置率、病理类型、术后并发症、非计划再就诊率、术后肿瘤同侧复发和对侧新发比率上比较,差异均无统计学意义(P＞0.05)。在腹腔镜手术组中,日间手术模式患儿住院时间和住院费用分别为(24.32±3.63)h和(9 288±1 752)元,非日间手术模式患儿分别为(92.52±37.69)h和(11 860±2 689)元,差异均有统计学意义(P＜0.05)。在机器人手术组中,日间手术模式患儿住院时间和住院费用分别为(24.62±1.02)h和(50 258±1 364)元,非日间手术模式患儿分别为(107.2±52.68)h和(53 615±2 246)元,差异均有统计学意义(P＜0.05)。机器人手术组与腹腔镜手术组在住院时间、手术时间、术后并发症等方面比较,差异均无统计学意义(P＞0.05),但住院费用较高(P＜0.05)。结论 日间手术模式下开展儿童卵巢良性肿瘤腹腔镜微创切除术或机器人辅助下微创切除术均安全可行;日间手术模式与非日间手术模式相比,治疗效果无显著差异,但缩短了住院时间,且减少了治疗费用,值得临床推广。
- Abstract:
- Objective To evaluate the safety and feasibility of laparoscopic and robot-assisted resection of benign ovarian tumors in children performed under a day-surgery model. Methods A retrospective analysis was conducted on clinical data from 327 cases of minimally invasive resection of benign ovarian tumors performed at the Children’s Hospital of Zhejiang University School of Medicine between January 2020 and December 2024.Patients were divided into a laparoscopic surgery group and a robotic surgery group based on the surgical approach.Differences in patient demographics,length of hospital stay,hospitalization costs,operative time,and postoperative complications were compared between the two surgical methods under both day-surgery and non-day-surgery models. Results All 327 pediatric patients successfully underwent minimally invasive resection of benign ovarian tumors.Regardless of whether the procedure was no statistically significant differences (P>0.05) between the day-surgery and non-day-surgery models in terms of patient age,geographic region,unilateral/bilateral tumor distribution,maximum tumor diameter,American Society of Anesthesiologists (ASA) classification,operative time,intra-operative blood loss,drainage tube placement rate,pathological type,postoperative complications,unplanned readmission rate,ipsilateral tumor recurrence,or contralateral new tumor occurrence.In the laparoscopic surgery group,the length of hospital stay and hospitalization cost under the day-surgery model were (24.32±3.63) hours and RMB 9,288±1,752,respectively,compared to (92.52±37.69) hours and RMB 11,860±2,689 in the non-day-surgery model.These differences were statistically significant (P<0.05).In the robotic surgery group,the length of hospital stay and cost under the day-surgery model were (24.62±1.02) hours and RMB 50,258±1,364,respectively,compared to (107.2±52.68) hours and RMB 53,615±2,246 in the non-day-surgery model,also statistically significant (P<0.05).When comparing the robotic and laparoscopic groups,there were no significant differences in hospital stay,operative time,or postoperative complications (P>0.05),though hospitalization costs were significantly higher in the robotic surgery group (P<0.05). Conclusions Minimally invasive laparoscopic or robot-assisted resection of benign ovarian tumors in children is both safe and feasible under the day-surgery model.Compared with the non-day-surgery model,the day-surgery approach yields equivalent treatment outcomes while significantly reducing hospital stay and medical costs.This model is worthy of broader clinical adoption.
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备注/Memo
收稿日期:2025-4-9。
通讯作者:王金湖,Email:wjh@zju.edu.cn