机器人辅助腹腔镜与传统腹腔镜输尿管再植术应用对比  

Comparison of robot-assisted versus traditional laparoscopic ureteral reimplantation

作　　者：赵冬艳 唐达星[1] 陶畅[1] 诸林峰 沈一丁[1] 孙珑 陈光杰[1] Zhao Dongyan;Tang Daxing;Tao Chang;Zhu Linfeng;Shen Yiding;Sun Long;Chen Guangjie(Department of Urology,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center For Children's Health,Hangzhou 310000,China)

机构地区：[1]国家儿童健康与疾病临床医学研究中心,浙江大学医学院附属儿童医院泌尿外科,杭州310000

出　　处：《中华小儿外科杂志》2022年第1期20-24,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的比较机器人辅助腹腔镜下输尿管再植术(robot-assisted laparoscopic ureteral reimplantation,RALUR)与传统腹腔镜下输尿管再植术(laparoscopic ureteral reimplantation,LUR)在治疗婴幼儿原发性梗阻性巨输尿管(primary obstructive megaureter,POM)的应用效果。方法收集2020年1月至2021年4月应用RALUR和LUR治疗POM的18例患儿资料。其中,男11例,女7例;手术年龄范围为0~36个月。将接受RALUR的10例患儿作为RALUR组,中位年龄为9个月,年龄范围为4~35个月;患侧为左侧6例,右侧4例。将接受LUR的8例患儿作为LUR组,中位年龄为10个月,年龄范围为5~25个月;患侧为左侧6例,右侧2例。结果所有手术均顺利完成,无中转开放。RALUR组的手术时间为(149.0±18.9)min,LUR组为(194.4±45.0)min,差异具有统计学意义(P=0.01);RALUR组住院费用为(73807.0±7342.2)元,LUR组为(23126.7±4497.1)元,差异具有统计学意义(P<0.001);RALUR组的术后拔引流管时间为(4.2±1.7)d,LUR组为(4.8±2.5)d,差异无统计学意义(P=0.59);RALUR组的术后住院时间为(9.0±2.5)d,LUR组为(9.6±1.6)d,差异无统计学意义(P=0.54)。18例患儿术后随访时间范围为3~19个月,RALUR组及LUR组各有2例因尿路感染行抗感染治疗,术后3个月复查排泄性膀胱造影均未见明显反流,术后均无需再次住院治疗的短期并发症发生。结论运用RALUR和LUR治疗婴幼儿POM均安全、有效且恢复迅速。RALUR的手术时间更短,是一种可行的手术选择。Objective To compare the therapeutic efficacy of robot-assisted laparoscopic ureteral reimplantation(RALUR)versus traditional laparoscopic ureteral reimplantation(LUR)for primary obstructive megaureter(POM)in infants.Methods From January 2020 to April 2021,clinical data were collected from 18 children undergoing RALUR/LUR for POM.There were 11 boys and 7 girls with an operative age from 0 to 36 months.Ten children undergoing RALUR were selected as RALUR group.The average age was 9(4-35)months.And the involved side was left(n=6)and right(n=4);Eight children undergoing LUR were selected as LUR group.The average age was 10(5-25)months.And the involved side was left(n=6)and right(n=2).Results All operations were successfully completed and there was no conversion to open surgery.The operative duration was(149.0±18.9)min in RALUR group and(194.4±45.0)min in LUR group and the inter-group difference had statistical significance(P=0.01);the hospitalization expenditure was(73807.0±7342.2)yuan in RALUR group and(23126.7±4497.1)yuan in LUR group and the inter-group difference had statistical significance(P<0.001);the postoperative drainage duration was(4.2±1.7)days in RALUR group and(4.8±2.5)days in LUR group and the inter-group difference had no statistical significance(P=0.59);the postoperative hospital stay was(9.0±2.5)days in RALUR group and(9.6±1.6)days in LUR group and the inter-group difference had no statistical significance(P=0.54).The postoperative follow-up period was 3 to 19 months.Two cases of urinary tract infection in both groups received antibiotics.Excretory cystography at Month 3 postoperatively showed no obvious complications.No short-term postoperative complications requiring rehospitalization occurred.Conclusions Both RALUR and LUR are safe,effective and rapid in the treatment of POM in infants.With a shorter operative duration,RALUR is a viable surgical option.

关 键 词：机器人 腹腔镜 原发性梗阻性巨输尿管 婴幼儿 

分 类 号：R726.9[医药卫生—儿科]