达芬奇机器人辅助腹腔镜下改良Swenson术治疗先天性巨结肠症的疗效研究  

Effect of Da Vinci robot-assisted laparoscopic modified Swenson procedure in children with Hirschsprung’s disease

作　　者：杨嘉飞 杜君 谷化剑 孙旭 徐忠敏 何坤凤 YANG Jiafei;DU Jun;GU Huajian;SUN Xu;XU Zhongming;HE Kunfeng(Clinical College of Guizhou Medical University,Guiyang 550025,China;Department of Pediatric Surgery,the Affiliated Hospital of Guizhou Medical University,Guiyang 550001,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550025 [2]贵州医科大学附属医院小儿外科,贵州贵阳550001

出　　处：《机器人外科学杂志（中英文）》2024年第4期666-670,共5页Chinese Journal of Robotic Surgery

基　　金：贵州省卫生健康委科学技术基金项目(gzwk2022-134)。

摘　　要：目的:总结达芬奇机器人辅助腹腔镜下改良Swenson术治疗儿童先天性巨结肠症的经验及短中期疗效。方法:以2020年6月—2022年8月贵州医科大学附属医院小儿外科行机器人辅助腹腔镜下改良Swenson术的28例先天性巨结肠症患儿为研究对象。采用达芬奇机器人Xi手术系统,经盆腔浆膜下游离直肠至齿状线附近,经肛门套叠后切除病变肠管,与正常肛管吻合。收集患儿的基本资料、手术参数和术后结果并进行回顾性分析。结果:所有患儿均顺利完成手术,无中转开腹,平均手术时间(165±34)min,平均手术出血量(9.8±5.2)ml,平均住院时间(10.54±4.25)d,平均随访时间(18.5±3.0)个月;近期术后并发症4例,其中3例肛周皮炎,1例小肠结肠炎;远期并发症3例,其中2例小肠结肠炎,1例肛周皮炎。结论:达芬奇机器人辅助腹腔镜下改良Swenson术是一种安全可行的手术方式,能够有效降低术后并发症的发生率。Objective:To investigate the mid-term outcomes and experience of Da Vinci Robot-assisted laparoscopic modified Swenson procedure for Hirschsprung’s disease(HSCR).Methods:From June 2020 to August 2022,28 children with HSCR who underwent Da Vinci robot-assisted laparoscopic modified Swenson operation in the Department of Pediatric Surgery,Affiliated Hospital of Guizhou Medical University were selected as the research objects.The Da Vinci Xi surgical system was used to separate rectum from its serosa to dentate line by keeping the anatomical plane away from the Denonvilliers’fascia and presacral fascia.After anal intussusception,the diseased section of bowel was removed.The normal intestinal canal was anastomosed to the anus using interrupted absorbable sutures.The general data,surgical indicators and postoperative outcomes of patients were collected and retrospectively analyzed.Results:All surgeries were successfully completed without conversion to laparotomy.The average operative time was(165±34)minutes,and the average blood loss was(9.8±5.2)ml,with an average hospital stay of(10.54±4.25)days and average follow-up time of(18.5±3.0)months.There were 4 cases of early postoperative complications,including 3 cases of perianal dermatitis and 1 case of colitis in small intestine.There were 3 cases of late complications,including 2 cases of colitis in small intestine and 1 case of perianal dermatitis.Conclusion:Da Vinci robot-assisted laparoscopic modified Swenson procedure is safe and feasible in the treatment of children with HSCR,which can effectively reduce the incidence of postoperative complications.

关 键 词：机器人辅助手术 先天性巨结肠 改良Swenson手术 并发症 

分 类 号：R726.5[医药卫生—儿科]