机器人辅助腹腔镜与传统腹腔镜在儿童肾盂成形术的应用价值  

Application value of robot-assisted versus traditional laparoscopic pyeloplasty in children

作　　者：李泸平[1] 张俊杰[1] 张胜利[1] 田广超 范应中[1] Li Luping;Zhang Junjie;Zhang Shengli;Tian Guangchao;Fan Yingzhong(Department of Pediatric Surgery,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院小儿外科,450052

出　　处：《中华小儿外科杂志》2022年第1期14-19,共6页Chinese Journal of Pediatric Surgery

摘　　要：目的评价机器人辅助腹腔镜在儿童肾盂成形术中的应用价值。方法收集2018年1月至2019年12月在郑州大学第一附属医院小儿外科接受肾盂成形术的170例患儿的相关资料。将接受腹腔镜肾盂成形术(laparoscopic pyeloplasty,LP)的102例患儿作为LP组,其中男56例,女46例;患侧为左侧79例,右侧23例;年龄为(46.83±33.72)个月。将接受机器人辅助腹腔镜肾盂成形术(robotic-assisted laparoscopic pyeloplasty,RALP)的68例患儿作为RALP组,其中男35例,女33例;患侧为左侧48例,右侧20例;年龄为(71.33±39.27)个月。本研究所有患儿的手术均由同一主刀医生完成。对比分析两种术式的手术时间、术中出血量、术后引流时间、住院时间、住院费用等临床指标。结果LP组患儿年龄低于RALP组,差异具有统计学意义(P<0.001),两组患儿的性别组成之间的差异以及患侧之间的差异均无统计学意义(P>0.05)。LP组和RALP组的手术时间[(126.81±31.16)min比(171.47±30.93)min]、住院费用[(2.65±0.39)万元比(4.73±0.40)万元],差异均具有统计学意义(P<0.05);LP组和RALP组的术中出血量[(8.21±3.38)ml比(7.81±3.89)ml]、术后引流时间[(4.79±2.35)d比(4.69±2.63)d]、术后住院时间[(10.83±2.31)d比(10.62±2.00)d],差异均无统计学意义(P>0.05)。术后随访时间范围为1~3年,所有患儿均手术成功,患肾积水减轻,肾功能不同程度恢复。结论两种术式手术效果相当,RALP在儿童肾盂成形术中,花费较LP高,手术时间偏长,LP更适合推广应用。Objective To explore the value of robot-assisted versus traditional laparoscopic pyeloplasty in children.Methods From January 2018 to December 2019,the relevant clinical data were collected from 170 children undergoing pyeloplasty.And 102 children of laparoscopic pyeloplasty(LP)were selected as LP group.There were 56 boys and 46 girls with the average age of(46.83±33.72)months.The involved side was left(n=79)and right(n=23).Another 68 of robotic-assisted laparoscopic pyeloplasty(RALP)were selected as RALP group.There were 35 boys and 33 girls with the average age of(71.33±39.27)months.The involved side was left(n=48)and right(n=20).All operations were performed by the same surgeon.Operative duration,volume of intraoperative blood loss,postoperative drainage duration,length of hospital stay and hospitalization expenditure of two groups were compared.Results The age was lower in LP group than that in RALP group and the inter-group difference was statistically significant(P<0.001).No significant inter-group difference existed in gender composition or involved side(P>0.05).Operative duration[(126.81±31.16)vs.(171.47±30.93)min]and hospitalization expenditure[(26500±3900)vs.(47300±4000)yuan]were significantly different(P<0.05);volume of intraoperative blood loss[(8.21±3.38)vs.(7.81±3.89)ml],postoperative drainage duration[(4.79±2.35)vs.(4.69±2.63)days]and postoperative hospital stay[(10.83±2.31)vs.(10.62±2.00)days]were not significantly different(P>0.05).The postoperative follow-up period was 1 to 3 years.All operations were successful.And hydronephrosis lessened and renal function recovered in certain degree.Conclusions Two surgical outcomes of pyeloplasty are equivalent.With a higher expenditure,RALP has a longer operative duration.In comparison,LP is more suitable for promotion and application.

关 键 词：机器人 腹腔镜 肾积水 肾盂成形术 儿童 

分 类 号：R726.9[医药卫生—儿科]