机器人辅助的直肠直肠切除术与 laparoscopic-assisted-soave pull-through对于赫施普朗格病:从一个前性的多中心研究中期结果
Mengxin Zhang1, Xi Zhang1, Shuiqing Chi1
1Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Annals of surgery
|December 11, 2023
概括
机器人辅助的直肠直肠切除术 (RAP) 和腹腔镜辅助的Soave pull-through (LAP) 在希尔施普朗格病 (HD) 中显示了类似的中期肠功能结果. 然而,RAP可能为3个月以下的婴儿提供功能益处,这需要进一步研究.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 最少侵入性的手术
背景情况:
- 至少侵入性技术,如腹腔镜辅助的前列腺瘤切除术 (LAP) 和机器人辅助的前列腺瘤切除术 (RAP),用于希尔施普隆病 (HD).
- RAP与LAP对HD的比较临床益处需要通过多中心前性研究进行验证.
研究的目的:
- 为了比较手术结果的机器人辅助proctosigmoidectomy (RAP) 和腹腔镜辅助Soave pull-through (LAP) 在患有赫斯普隆病 (HD) 的儿童.
- 评估4岁及以上儿童的中期功能结果.
主要方法:
- 未来的多中心临床试验 (2015年7月至2022年6月) 涉及患有直交形/下降性HD的儿童.
- 在随访时年龄≥4岁的患者中,LAP和RAP组之间的肠功能评分的比较.
- 分析手术参数,包括经切割长度和引时间.
主要成果:
- 219名患者 (≥4年) 完成了随访 (RAP=109,LAP=110).
- 与LAP相比,RAP表现出明显更短的过口剖析长度和口引时间.
- RAP组表现出较低的尿留率 (0%对5.52%). 中期肠功能得分相似,但在<3个月后手术的婴儿与RAP的门休息压力和禁欲得分更好.
结论:
- 机器人辅助的直肠直肠切除术 (RAP) 和腹腔镜辅助的Soave pull-through (LAP) 在希尔施普朗格病 (HD) 中产生了类似的中期功能结果.
- 在3个月前手术的婴儿中,RAP可能会提供轻微的功能优势.
- 建议在更大的队列中进行进一步的研究,以确认RAP在特定婴儿子组中的好处.
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