机器人辅助腹腔镜手术在儿童上尿路修复重建中的应用  

Robot-assisted laparoscopic upper urinary tract reconstruction in children

作　　者：梅红[1] 李聃 金环 童强松[1] 练恒 郭艳华 李康 汤绍涛[1] MEI Hong;LI Dan;JIN Huan;TONG Qiangsong;LIAN Heng;GUO Yanhua;LI Kang;TANG Shaotao(Department of Pediatric Surgery,Union Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院小儿外科,湖北武汉430022

出　　处：《机器人外科学杂志（中英文）》2023年第2期113-120,共8页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金资助项目(81773094)。

摘　　要：目的:分析总结机器人辅助腹腔镜手术在儿童上尿路修复重建手术中的应用经验及治疗效果。方法:回顾性分析2019年5月—2020年5月在本中心完成的35例行机器人辅助腹腔镜下儿童上尿路修复重建手术患儿的临床资料,包括离断性肾盂成形术28例,肾盂瓣肾盂输尿管成形术4例,输尿管-输尿管吻合术3例。所有患儿术后随访时间均超过6个月,常规行泌尿系超声和分肾功能等检查。结果:全部手术均在机器人辅助腹腔镜下成功完成,无中转开放性手术。28例行机器人辅助腹腔镜下离断性肾盂成形术患者的平均手术时间(168.5±35.9)min,术中出血量10(0~20)ml,平均术后住院时间(9.8±1.4)d;4例行机器人辅助腹腔镜下肾盂瓣成形术患者的平均手术时间(209.0±46.7)min,术中出血量17.5(15~20)ml,平均术后住院时间(11.0±1.4)d;3例行机器人辅助腹腔镜下输尿管-输尿管吻合术患者的平均手术时间(183.0±13.2)min,术中出血量10(5~15)ml,平均术后住院时间(9.6±0.6)d。结论:机器人辅助腹腔镜手术在儿童上尿路疾病修复重建手术中的应用取得了较好效果,操作较易掌握,临床应用前景较好。但是,未来仍需要更大样本的前瞻性观察研究及长期随访数据,以进一步评估其有效性和安全性,尤其是在复杂病例中的应用。Objective:To analyze and summarize the preliminary experience and therapeutic effect of robot-assisted laparoscopic reconstruction on upper urinary tract in children.Methods:The clinical data of 35 children who underwent robot-assisted laparoscopic upper urinary tract reconstruction in the Department of Pediatric Surgery of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2019 to May 2020 were retrospectively reviewed,including 28 cases of dismembered pyeloplasty,4 cases of pyelo-ureteroplasty and 3 cases of ureteroureterostomy.All patients were followed up for more than 6 months with routine urinary ultrasound and split renal function testing.Results:All the surgeries were successfully completed with no conversion to open surgery.The average operative time of 28 cases of robot-assisted laparoscopic dismembered pyeloplasty was(168.5±35.9)min,with intraoperative blood loss of 10(0-20)ml.The average postoperative hospital stay was(9.8±1.4)d.The average operative time of 4 cases of robot-assisted laparoscopic pyelo-ureteroplasty was(209.0±46.7)min,with intraoperative blood loss of 17.5(15-20)ml.The average postoperative hospital stay was(11.0±1.4)d.The average operative time of 3 cases of robotassisted laparoscopic ureteroureterostomy was(183.0±13.2)min,with the intraoperative blood loss of 10(5-15)ml and the average postoperative hospital stay of(9.6±0.6)d.Conclusion:Robot-assisted laparoscopic surgery could be used in the repair and reconstruction of upper urinary tract in children with good results.The operation is relatively easy to master and of good clinical prospect.However,prospective observational studies with larger samples and longer term follow-up data shall be performed to further evaluate its effectiveness and safety,especially in complex cases.

关 键 词：机器人辅助腹腔镜手术 儿童 上尿路修复重建手术 肾盂成形术 

分 类 号：R726.9[医药卫生—儿科]