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腹腔镜和机器人辅助腹腔镜再植入用于下尿道病理. 一项多机构对1343名患者进行的比较研究

Leon Chertin¹, Stanislav Kocherov¹, Pavel Bakaleyshchik¹

¹Shamir Medical Center, Be'er Ya'akov, Israel.

|February 24, 2024

概括

儿科机器人和腹腔镜手术有效地治疗膀管外流 (VUR) 和阻塞性大尿道 (OM). 机器人辅助的方法为接受尿道再植入的儿童提供了更短的手术时间和更少的并发症.

科学领域:

儿科泌尿外科儿科泌尿外科
最少侵入性的手术
尿道瘤学尿道瘤学

背景情况:

阴道尿道逆流 (VUR) 和阻塞性大尿道 (OM) 是常见的儿科泌尿病状况.
治疗儿童VUR和OM时,通常需要进行手术.
腹腔镜和机器人辅助技术越来越多地用于儿科泌尿外科手术.

研究的目的:

评估和比较为VUR和OM进行手术纠正的儿科患者的结果.
评估各种腹腔镜和机器人辅助手术方法在下尿道病理方面的疗效和安全性.
确定机器人辅助手术在儿科泌尿器重建中比传统腹腔镜有什么好处.

主要方法:

来自13个国际学术中心的儿科病例 (2016-2022) 的回顾性审查.
分析了五种外科手术方法:腹腔镜外带尿道再植入 (LEUR),腹腔镜囊尿道再植入 (LVCUR),腹腔镜远距离切除和再植入 (LDECUR),机器人辅助腹腔镜尿道再植入 (RALUR) 和机器人辅助远距离切除和再植入 (RADECUR).
根据患者人口统计和随访数据评估手术时间,并发症率和手术成功率.

主要成果:

总共包括1343名儿科患者 (平均年龄30个月),其中68%为VUR治疗,32%为OM治疗.
与腹腔镜 (240分钟) 相比,机器人辅助手术的中位数手术时间较短 (202分钟),尽管在统计学上并不显著 (P=0.45).
整体手术成功率高 (96%),残留逆流率低 (5.6%) 和小并发症 (0.4-1.2%) 在两种方法中,有利于机器人手臂减少3级并发症.

结论:

腹腔镜和机器人辅助手术是治疗儿科VUR和OM的安全和有效方法.
机器人辅助方法在操作时间,体内接能力和并发症率降低方面表现出优势.
这些微创手术技术为管理复杂的儿科下尿道病理提供了成功的结果.

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