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Updated: May 29, 2026
Technical Considerations and Approach to Redo Foregut Surgery
Published on: September 22, 2023
Robotic surgery for pediatric foregut cysts resection: A preliminary investigation and comparative study with the
1Department of Pediatric Thoracic Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health and Adolescents' Health and Diseases, Hangzhou 310052, Zhejiang, China.
Objective:
Resection of foregut cysts in children is technically challenging. Video-assisted thoracoscopic surgery (VATS) is currently the most commonly adopted surgical approach. This study aimed to compare the safety and efficacy of robot-assisted thoracoscopic surgery (RATS) and VATS for the treatment of pediatric foregut cysts.
Methods:
This single-center, retrospective study enrolled pediatric patients with foregut cysts who underwent RATS or VATS from January 2020 to June 2025. Demographic characteristics, intraoperative features and postoperative outcomes were analyzed and compared between the two groups.
Results:
A total of 66 patients met the inclusion criteria, with 39 patients in the RATS group and 27 patients in the VATS group. No significant differences were observed between the two groups in age, sex, weight, cyst type, maximal cyst diameter, effective operative time (excluding setup time) and intraoperative blood loss (P = 0.779, P = 0.508, P = 0.901, P = 0.497, P = 0.814, P = 0.528 and P = 0.327, respectively). Total operative time was significantly longer in the RATS group (P = 0.021). Compared with the VATS group, patients in the RATS group demonstrated significantly lower intensive care unit (ICU) admission, lower 24-h drainage volume, shorter postoperative hospital stay, shorter chest tube duration and lower incidence of postoperative complications (P < 0.01, P = 0.036, P = 0.012, P = 0.01 and P = 0.019, respectively). However, the overall hospitalization costs in the RATS group were significantly higher than those in the VATS group (P < 0.01).
Conclusion:
RATS is a safe and effective treatment for pediatric foregut cysts and is associated with improved outcomes compared with VATS.
Level Of Evidence:
LEVEL III.
