首页|机器人辅助左半结肠切除、Soave吻合术治疗儿童巨结肠同源病

机器人辅助左半结肠切除、Soave吻合术治疗儿童巨结肠同源病

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目的 总结机器人辅助左半结肠切除、Soave吻合术治疗巨结肠同源病的经验与优势.方法 2015年6月~2022年11月间采用左半结肠切除、Soave吻合术治疗巨结肠同源病19例,总结19例患儿的临床资料.手术采用四孔法,先行普通腹腔镜游离结肠脾曲至直肠腹膜返折,对接机器人后游离直肠至齿状线附近.手术转至会阴部,齿状线上0.5 cm处开始游离直肠黏膜进入游离腹腔,无张力拖出结肠予以切除,行结肠直肠Soave吻合.同期普通腹腔镜辅助左半结肠切除、Soave吻合术21例.比较两组围术期指标,术后近期并发症.结果 所有患儿均在机器人辅助下一期完成左半结肠切除、Soave吻合术,与普通腹腔镜辅助下左半结肠切除、Soave吻合术组相比较,手术时间明显延长(P<0.01),术中出血量明显减少(P<0.01),术后总并发症发生率明显降低(11%vs.43%,P<0.05).无大出血、死亡等严重并发症.结论 机器人辅助下左半结肠切除、Soave吻合术治疗巨结肠同源病安全可行,术后并发症少,可获满意的临床疗效.
The primary experience of the robotic assisted left hemicolectomy and Soave procedure for Hirschsprung's disease in children
Objective To introduce the robotic-assisted left hemicolectomy and Soave procedure and its clinical outcome for Hirschsprung's allied disease.Methods From June 2015 to November 2022,19 cases diagnosed with Hirschsprung's allied disease underwent left colectomy and Soave pull-through by using the da Vinci surgical system,and the clinical data of 19 children were summarized and analyzed.A four trocar technique was used.The left colon was firstly mobilized by laparoscopy from splenic flexure of colon to the level of peritoneal reflection,then the rectum was mobilized by Robotic system to the level of dentate line.A circumferential incision was made in the mucosa at 0.5 cm proximal to the dentate line.The upward submucosal dissection was carried out for approximately 1-2 cm.The left colon was pulled through the anal canal and resected.The coloanal anastomosis was fashioned manually 0.5 cm above the dentate line.21 cases underwent conventional laparoscopic-assisted Soave surgery were used as control group.Results All patients were successfully operated.Compared with conventional laparoscopic-assisted Soave surgery,the operation time was significantly prolonged(P<0.01),the intraoperative blood loss was significantly reduced(P<0.01),and the overall postoperative complication rate was significantly reduced(11%VS.43%,P<0.05).There were no serious complications such as major bleeding and death.Conclusion Robotic-assisted left hemicolectomy and Soave procedure are safe and feasible in the treatment of Hirschsprung's allied disease,with few postoperative complications and satisfactory clinical outcome.

hirschsprung's allied diseaserobotic systemSoave

唐凌、毛永忠、江凌、普佳睿、杨德华、汤绍涛

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430022 武汉,华中科技大学同济医学院附属协和医院小儿外科

巨结肠同源病 机器人手术 Soave术式

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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