达芬奇机器人与腹腔镜在儿童肠重复畸形切除术中的应用对比研究  

Comparative study of Da Vinci technique versus traditional laparoscopy in the treatment of intestinal duplication

作　　者：金益 陈青江[1] 章跃滨[1] 蔡多特[1] 陈肯[1] 罗文娟[1] 黄宗伟 胡迪 张书豪 温李平 高志刚[1] Jin Yi;Chen Qingjiang;Zhang Yuebin;Cai Duote;Chen Ken;Luo Wenjuan;Huang Zongwei;Hu Di;Zhang Shuhao;Wen Liping;Gao Zhigang(Department of General Surgery,Children's Hospital,Zhejiang University school of Medicine,National Clinical Research Center for Children's Health,Zhejiang Clinical Research Center of Mini-invasive Diagnosis&Treatment of Abdominal Diseases,Hangzhou 310053,China)

机构地区：[1]浙江大学医学院附属儿童医院普外科,国家儿童健康与疾病临床医学研究中心,浙江省腹腔脏器微创诊治临床医学研究中心,杭州310053

出　　处：《临床小儿外科杂志》2022年第7期632-636,共5页Journal of Clinical Pediatric Surgery

基　　金：浙江省卫生健康科技计划(2022RC201)。

摘　　要：目的对比分析达芬奇机器人与传统腹腔镜在儿童肠重复畸形切除术中的应用效果。方法回顾性分析浙江大学医学院附属儿童医院普外科腔镜中心2020年4月至2021年12月完成的44例行达芬奇机器人和传统腹腔镜辅助肠重复畸形切除术患儿的临床资料,根据术式的不同分为达芬奇手术组(n=14)和腹腔镜手术组(n=30)。比较两组手术时长、术后禁食时间、术后住院天数、住院费用等指标,分析两种手术方法的优劣。结果达芬奇手术组手术时长为(85.57±18.88)min,腹腔镜手术组手术时长为(84.33±19.82)min,差异无统计学意义(t=0.196,P=0.846)。达芬奇手术组均在腹腔内完整剥离肿物,无需行肠切除肠吻合;达芬奇手术组术后禁食时间为3(2,3.25)d,腹腔镜手术组为4(4,5)d,差异有统计学意义(Z=-3.493,P<0.001)。术后住院时长比较,达芬奇手术组为6(4.75,6.25)d,腹腔镜手术组为7.5(6,10)d,差异有统计学意义(Z=-3.679,P<0.001)。住院费用比较,达芬奇手术组为6.4(6.1,6.8)万元,腹腔镜手术组为1.7(1.4,2.0)万元,差异有统计学意义(Z=-5.292,P<0.001)。结论儿童达芬奇机器人肠重复畸形切除术是一项安全可行的新技术,较传统腹腔镜手术解剖更清晰,操作更精细,患儿术后恢复更快。Objective To compare the application outcomes of Da Vinci robot versus traditional laparoscope in the resection of intestinal duplication in children.Methods Between April 2020 and December 2021,retrospective review was conducted for 44 children of intestinal duplication undergoing surgery.They were divided into two groups of robot surgery(n=14)and laparoscopic-assisted surgery(n=30).The relevant clinical data of operative duration,postoperative fasting time,postoperative hospital stay and hospitalization expenses were compared between two groups.Results The operative durations of robot surgery and laparoscopic-assisted surgery groups were[(85.57±18.88)vs.(84.33±19.82)min].There was no significant inter-group statistical difference(t=0.196,P=0.846).Intestinal duplication was completely peeled off by endoscope in robot surgery group,intestinal integrity was preserved and intestinal resection and anastomosis were not required.Postoperative fasting time was 3(2,3.25)versus 4(4,5)days and the difference was statistically significant(Z=-3.493,P=<0.001).The postoperative length of hospital stay was 6(4.75,6.25)days in robot operation group and 7.5(6,10)days in laparoscopic-assisted operation group(Z=-3.679,P<0.001).And hospitalization expenses was 64000 yuan in Da Vinci operation group and 17000 yuan in laparoscopic-assisted operation group(Z=-5.292,P<0.001).Conclusion Da Vinci robot resection of intestinal duplication is both safe and feasible in children.Its preciseness is much better than that of conventional laparoscopy so that patients may recover faster after operation.

关 键 词：消化系统畸形/外科学 肠/外科学 最小侵入性外科手术 机器人手术 腹腔镜检查 

分 类 号：R726.5[医药卫生—儿科]