传统单孔腹腔镜与机器人辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的疗效比较  

Efficacy comparison of conventional laparoscopy versus robot-assisted transumbilical single-incision laparoscopy for benign ovarian lesions in children and adolescents

作　　者：骆明双 高贺云 易跃雄[2] 张蔚[2] 郭云凯 余山桢 张欣[1] 张文[1] Luo Mingshuang;Gao Heyun;Yi Yuexiong;Zhang Wei;Guo Yunkai;Yu Shanzhen;Zhang Xin;Zhang Wen(Department of Pediatric Surgery,Zhongnan Hospital,Wuhan University,Wuhan 430071,China;Department of Gynecology,Zhongnan Hospital,Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院小儿外科,武汉430071 [2]武汉大学中南医院妇科,武汉430071

出　　处：《临床小儿外科杂志》2024年第6期567-571,共5页Journal of Clinical Pediatric Surgery

基　　金：武汉大学中南医院学科建设项目(YYXKNLJS2024020)

摘　　要：目的初步比较第四代达芬奇机器人辅助单孔腹腔镜手术与传统单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的临床效果。方法回顾性分析2018年1月至2023年3月在武汉大学中南医院行第四代达芬奇机器人辅助单孔腹腔镜手术和传统单孔腹腔镜手术的儿童及青少年卵巢良性病变患者临床资料,采取第四代达芬奇机器人辅助单孔腹腔镜手术(robot-assisted laparoscopic single port surgery,R-LESS)13例(R-LESS组),采取传统单孔腹腔镜手术(laparoscopic single port surgery,LESS)22例(LESS组)。统计两组患儿手术时间、术中出血量、卵巢扭转情况、卵巢肿瘤体积、术中有无卵巢肿瘤破裂、是否放置引流管、术后并发症发生率、住院时间、住院费用以及随访情况。结果R-LESS组与LESS组手术时间[161.38(103.00,201.00)min比136.31(100.50,171.50)min]、术中出血量[21.15(10.00,32.50)mL比45.23(10.00,50.00)mL]、卵巢扭转发生率(15%比32%)、术中卵巢肿瘤破裂发生率(23%比36%)、引流管放置率(23%比23%)、术后并发症发生率(8%比6%)以及随访时间[20.70(11.00,29.50)个月比28.09(9.25,46.25)个月]比较,差异均无统计学意义(P>0.05);R-LESS组较LESS组术后住院时间减少[4.23(3.00,5.00)d比5.05(3.75,6.25)d],住院费用增多[(40557.01±4036.29)元比(26456.32±6413.30)元],差异有统计学意义(P<0.05)。结论R-LESS手术治疗儿童及青少年卵巢良性病变安全可行。与LESS手术相比,R-LESS术后患儿恢复更快,但住院费用较高。R-LESS手术可作为治疗儿童及青少年卵巢良性病变的一种选择,未来仍需进行大样本对比研究以进一步验证。Objective To preliminarily compare the surgical efficacies of generation IV Leonardo da Vinci robot-assisted single-incision laparoscopy versus traditional single-incision laparoscopy for benign ovarian lesions in children and adolescents.Methods From January 2018 to March 2023,the relevant clinical data were retrospectively reviewed for children and adolescents undergoing fourth generation IV Da Vinci robot-assisted single-hole laparoscopy(R-LESS,n=13)and traditional single-hole laparoscopy(LESS,n=22)for benign ovarian lesions.Operative duration,intraoperative volume of blood loss,ovarian torsion,ovarian tumor volume,intraoperative tumor rupture,placement of drainage tube,postoperative complication rate,postoperative hospitalization stay,hospitalization expense and follow-up time were recorded.Results As compared with LESS group,no significant inter-group differences existed in operative duration[161.38(103-201)vs.136.31(100.50-171.50)min],intraoperative volume of blood loss[21.15(10-32.50)vs.45.23(10-50)mL],incidence of ovarian torsion(15%vs.32%),intraoperative incidence of ovarian tumor rupture(23%vs.36%),placement of drainage tube(23%vs.23%),incidence of postoperative complications(8%vs.6%)or follow-up time[20.70(11,29.5)vs.28.09(9.25,46.25)month].As compared with LESS group,length of postoperative hospitalization declined[4.23(3-5)vs.5.05(3.75-6.25)day]and hospitalization expense spiked[(40557.01±4036.29)vs.(26456.32±6413.30)yuan]in R-LESS group with statistical significance(P<0.05).Conclusions R-LESS is both safe and feasible for treating benign ovarian lesions in children and adolescents.As compared with LESS,R-LESS children recover more quickly post-operation.However,hospitalization expense is higher.Thus R-LESS is indicated for benign ovarian lesions in children and adolescents.In the future,large-scale comparative studies are still required for further verifications.

关 键 词：卵巢良性病变 腹腔镜检查 机器人手术 外科手术 治疗结果 儿童 青少年 

分 类 号：R713.6[医药卫生—妇产科学]