机器人手术在儿童胆总管囊肿术后吻合口狭窄再手术中的应用  

Application of robotic surgery for reoperation of anastomotic stenosis after choledochal cyst operation in children

作　　者：王真真 张大[1] 高志刚[2] 熊启星[2] 罗文娟[2] 杨林[1] 贾佳[1] Wang Zhenzhen;Zhang Da;Gao Zhigang;Xiong Qixing;Luo Wenjuan;Yang Lin;Jia Jia(Department of Pediatric Surgery,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China;Center of General Endoscopy,Affiliated Children's Hospital,Medical College of Zhejiang University,Hangzhou 310003,China)

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450052 [2]浙江大学医学院附属儿童医院普外腔镜中心,杭州310003

出　　处：《中华小儿外科杂志》2022年第2期132-136,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的总结达芬奇机器人手术在小儿胆总管囊肿术后胆肠吻合口狭窄再手术中的应用经验,初步探讨其安全性及疗效。方法收集自2016年1月至2020年12月于郑州大学第一附属医院小儿外科及浙江大学医学院附属儿童医院普外腔镜中心因胆总管囊肿术后胆肠吻合口狭窄接受机器人辅助再手术的7例患儿临床资料,男4例,女3例,月龄31~156个月,7例患儿均有不同程度的肝功能损伤,其中5例患儿表现为腹痛,1例患儿表现为黄疸,1例患儿表现为腹痛伴发热。结果共有7例患儿因胆总管囊肿术后胆肠吻合口狭窄接受机器人辅助下再手术,手术时间(62.4±22.9)min,术中估计出血量(4.6±1.6)ml,术后开始进食时间(3.1±0.4)d,术后拔除腹腔引流管时间(4.6±1.0)d,术后住院时间(6.7±0.8)d。所有患儿均顺利完成手术,肝功能明显改善,术后恢复良好,随访时间3个月,无一例出现严重并发症。结论达芬奇机器人辅助下胆总管囊肿术后胆肠吻合口狭窄再手术安全可靠,操作精准灵活,并具有微创、美容等优势,整体效果良好,值得进一步推广。Objective To summarize the application experience of Da Vinci robotic surgery for reoperation of anastomotic stenosis after pediatric choledochal cyst surgery and to preliminarily explore its safety and efficacy.Methods From January 2016 to December 2020,retrospective review was performed for clinical data of 7 children undergoing robot-assisted reoperation due to anastomotic stenosis after choledochal cyst surgery.There were 4 boys and 3 girls with an age range of 31 to 156 months.They had liver function injury of varying degrees.The major symptoms were abdominal pain(n=5),jaundice(n=1)and abdominal pain&fever(n=1).Results All of them underwent robot-assisted reoperation of choledochal cyst due to postoperative anastomotic stenosis.The average operative duration was(62.4±22.9)min,estimated intraoperative blood loss(4.6±1.6)ml,postoperative time to resume feeding(3.1±0.4)days and postoperative time to removing abdominal drainage tube(4.6±1.0)days.The postoperative hospital stay was(6.7±0.8)days.All children successfully completed operation.Liver function significantly improved with an excellent postoperative recovery.During a follow-up period of 3 months,no complications occurred.Conclusion Reoperation of choledochal cyst assisted by Da Vinci robot is safe,reliable,accurate and flexible.It offers the advantages of mini-invasiveness and cosmetics.With a decent overall effect,it is worthy of a wider promotion.

关 键 词：胆总管囊肿 达芬奇机器人 吻合口狭窄 再手术 

分 类 号：R726.5[医药卫生—儿科]