机器人辅助腹腔镜手术在儿童脐尿管残留畸形手术中的应用  

Robot-assisted laparoscopic surgery for urachal remnant anomalies in children

作　　者：李文海 王海斌 郑凯 李欢 王武 杨俊 卞红强 LI Wenhai;WANG Haibin;ZHENG Kai;LI Huan;WANG Wu;YANG Jun;BIAN Hongqiang(School of Medicine,JiangHan University,Wuhan 430056,China;不详)

机构地区：[1]江汉大学医学部,武汉430056 [2]武汉儿童医院普外科

出　　处：《临床外科杂志》2024年第12期1305-1308,共4页Journal of Clinical Surgery

摘　　要：目的 探讨机器人辅助腹腔镜手术治疗儿童脐尿管残留畸形的治疗经验。方法2021年7月~2023年7月收治的10例脐尿管残留畸形患儿,采用机器人辅助腹腔镜手术治疗,分析术中情况、术后并发症、手术效果、病理结果等。结果 10例脐尿管残留畸形均经达芬奇机器人辅助腹腔镜手术完整切除,无中转开放手术,均保留脐部完整性,其中8例有症状者术前经影像学诊断后切除,1例无症状者因囊肿持续增大而切除,1例于其他术中发现一并切除。平均手术时间(140.70±17.66)分钟,中位失血7.5(4.5,27.5)ml,尿管留置(6.2±1.26)天,术后住院(9.9±0.94)天,平均费用(46 378.92±2 777.13)元。病理检查证实均为脐尿管残留畸形(其中9例为脐尿管囊肿,1例为脐尿管瘘)。结论 机器人辅助腹腔镜手术治疗儿童脐尿管残留畸形安全有效,针对前腹壁的切除后修复手术操作具备独特优势。Objective To explore the experience of robot-assisted laparoscopic surgery in the treatment of residual malformation of urachus with children.Methods The clinical date of 10 children with urachal remnants malformation treated by Da Vinci Robot Assisted Laparoscopic Surgery in Wuhan Children’s Hospital from July 2021 to July 2023 were retrospectively analyzed.Robot-assisted laparoscopic surgery was used to analyze the intraoperative situation,postoperative complications,surgical effect and pathological results.Results All 10 cases were treated by Da Vinci Robot Assisted Laparoscopic Surgery without Laparotomy and complete excision,while maintain the umbilical integrality,8 cases with symptoms were resected after preoperative imaging diagnosis,1 case was asymptomatic and resected due to continuous enlargement of the cyst,and 1 case was found to be resected during other operations.The average operation time was(140.70±17.66)min,the median blood loss was 7.5(4.5,27.5)ml,the postoperative urethral catheterization was(6.2±1.26)d,the hospital stay was(9.9±0.94)d and the average cost was(46378.92±2777.13)yuan.All the urachal remnants were confirmed by Pathology as 9 cases of urachal cysts and 1 case of urachal fistula.Conclusion Robot-assisted laparoscopic surgery is safe and effective in the treatment of urachal remnants malformation in children,the surgical procedure for resected repair of the anterior abdominal wall has unique advantages.

关 键 词：机器人辅助腹腔镜 儿童 脐尿管残留 脐尿管囊肿 

分 类 号：R73[医药卫生—肿瘤]