Gan Yuanzhu,Zheng Zebing,Wang Huijuan,et al.A comparative study of robot-assisted versus traditional laparoscopy for annular pancreas in neonates[J].Journal of Clinical Pediatric Surgery,2025,(06):542-547.[doi:10.3760/cma.j.cn101785-202502032-007]
机器人辅助与腹腔镜辅助手术治疗新生儿环状胰腺的对比研究
- Title:
- A comparative study of robot-assisted versus traditional laparoscopy for annular pancreas in neonates
- Keywords:
- Annular Pancreas; Infant Newborn; Robotic Surgery; Laparoscopy Surgery; Therapeutic Outcome
- 摘要:
- 目的 比较达芬奇机器人辅助与腹腔镜辅助十二指肠菱形吻合术治疗新生儿环状胰腺的疗效与安全性。方法 回顾性分析2021年1月至2024年6月遵义医科大学附属医院收治的35例环状胰腺患儿临床资料,根据手术方式的不同分为机器人手术组(n＝14)和腹腔镜手术组(n＝21)。比较两组手术时间、肠吻合时间、术中出血量、术后肠内营养时间、完全经口喂养时间、引流管拔除时间、术后住院时间、住院费用等指标。结果 与腹腔镜手术组相比,机器人手术组的手术时间较长[(184.6±25.4)min比(159.7±26.1)min],肠吻合时间显著缩短[(35.8±2.4)min比(47.7±4.2)min],术中出血量更少[(35.8±2.4)min比(47.7±4.2)min];拔除引流管的时间更早[4.0(3.0,4.25)天比5(5.0,6.0)天],住院费用较高[4.0(3.8,4.2)万元比2.4(2.3,2.5)万元],以上差异均具有统计学意义(P<0.05)。两组在术后住院时间、术后肠内营养时间、完全经口喂养时间及术后并发症发生率方面比较,差异无统计学意义(P>0.05)。两组术后均无一例发生吻合口瘘、吻合口狭窄、再次手术或意外再住院等。结论 机器人手术系统用于新生儿环状胰腺手术安全可行,术中出血少,降低了十二指肠吻合的难度,短期预后好。
- Abstract:
- Objective To compare the effectiveness and safety of Da Vinci robotic surgery versus laparoscopic-assisted duodenal rhomboid anastomosis for annular pancreas in neonates. Methods From January 2021 to June 2024,the relevant clinical data were retrospectively reviewed for 35 neonates hospitalized with annular pancreas.Based upon different surgical approaches,they were assigned into two groups of robotic surgery (n=14) and laparoscopy (n=21).Operative duration,intestinal anastomosis time,intraoperative volume of blood loss,postoperative enteral nutrition time,full oral feeding time,drainage tube removal time,postoperative hospital stay and hospitalization expense were compared between two groups. Results Significant inter-group differences existed in several key parameters.Robotic group exhibited a longer total operation time[(184.6±25.4) vs. (159.7±26.1) min].Robotic surgical group showed a significantly shorter intestinal anastomosis time [(35.8±2.4) vs. (47.7±4.2) min].There were also less volume of intraoperative blood loss [4.0 mL (IQR:3.0,5.0) vs. 6.0 mL (IQR 5.0,7.5)]and earlier drainage tube removal [4.0 day (IQR:3.0,4.25) vs. 5.0 day (IQR:5.0,6.0)].However,robotic group incurred higher hospitalization expense [40000(IQR:38000,42000) vs. 24000 (IQR:23000,25000) yuan].No significant inter-group differences existed in postoperative hospitalization stay,time to initiate enteral nutrition,full oral feeding time or postoperative complication rate (P>0.05).Importantly,neither group experienced such severe complications as anastomotic leakage,anastomotic stenosis,reoperation or unplanned rehospitalization. Conclusions Da Vinci robotic surgical system has proven both safe and feasible in surgical management of neonatal annular pancreas,demonstrating minimal intraoperative blood loss,lower technical complexity in enteric anastomosis and excellent short-term clinical outcomes.
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备注/Memo
收稿日期:2025-2-17。
基金项目:黔科合基础-ZK[2023]一般555
通讯作者:金祝,Email:915884700@qq.com