Tan Zheng,Yu Jiangeng,Liang Liang,et al.Robot-assisted thoracoscopy in the treatment of congenital pulmonary diseases in children[J].Journal of Clinical Pediatric Surgery,2021,20(08):708-711.[doi:10.12260/lcxewkzz.2021.08.002]
机器人辅助胸腔镜技术治疗小儿先天性肺部疾病的单中心研究
- Title:
- Robot-assisted thoracoscopy in the treatment of congenital pulmonary diseases in children
- Keywords:
- Robotic Surgical Procedures; Pneumonectomy; Thoracoscopy; Child
- 分类号:
- R563;R726.1
- 摘要:
- 目的 探索应用机器人辅助胸腔镜下进行小儿先天性肺部疾病手术的安全性、有效性及在微创手术中的优势。方法 2020年5月至2021年3月，浙江大学医学院附属儿童医院应用机器人辅助胸腔镜对85例临床拟诊为先天性肺部疾病的患者行手术治疗，其中男54例，女31例，年龄6个月15天至12岁10个月，平均（17.56±7.35）个月。所有病例手术通过1个8 mm观察孔、2个8 mm操作孔和1个5 mm辅助切口完成，手术过程中不撑开肋骨。对患者围手术期资料进行分析，总结经验。结果 85例患者手术均获得成功，包括解剖性肺叶切除术、肺段切除术、锲形切除术、囊肿剥离术和叶外隔离肺切除术，其中中转开胸手术1例。无一例发生围术期并发症或死亡。胸腔引流管留置时间0~5 d，平均（1.38±0.87） d；住院时间4~10 d，平均（6.23±1.25） d；手术时间42~270 min，平均（74.76±30.21） min；术中出血量1~30 mL，平均（4.05±2.21） mL；住院总费用61 897~95 033元，平均（70 426.65±6 086.78）元。所有患者围术期未行输血治疗。结论 机器人辅助胸腔镜行肺叶切除术安全有效，由于该技术具有更逼真的视野、更灵活稳定的操作而具备更宽泛的手术适应证，是胸部微创手术的新选择。
- Abstract:
- Objective To explore the safety, efficacy and advantages of da Vinci Xi robot-assisted thoracoscopy for children with congenital pulmonary diseases. Methods From May 2020 to March 2021, 85 children with clinically suspected congenital lung disease were operated with da Vinci Xi robot-assisted thoracoscopy. There were 54 boys and 31 girls with an average monthly age of (17.56±7.35)(6.5-130). There were 1 observation port (8 mm), 2 handling ports (8 mm) and 1 accessory incision (5 mm). Ribs were not stretched. The perioperative patient data were collected. Results All 85 operations were successful, including anatomical lobectomy, segmentectomy, pericardial resection, cyst dissection and extralobar isolated pneumonectomy. Only 1 case was converted into thoracotomy. No perioperative complications or death occurred. The average duration of chest irrigation was(1.38±0.87)(0-5) days, the average operative duration(74.76±30.21)(42-270) min, the average intraoperative volume of blood loss(4.05±2.21)(1-30) ml and the average total hospitalization expense(70 426.65±6 086.78)(61 897-95 033) yuan. No blood transfusion was offered during perioperative period. Conclusion Robot-assisted thoracoscopic lobectomy is both safe and effective with more realistic vision, more flexible and stable handling and a wider surgical indication. It is an important option for a new generation of mini-invasive thoracic surgery.
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备注/Memo
收稿日期:2021-03-28。
基金项目:国家重点研发计划（编号：2018YFC1002700）
通讯作者:谭征,Email:tanzheng@zju.edu.cn