达芬奇机器人辅助改良Soave术治疗先天性巨结肠临床疗效评估

Clinical efficacy of Da Vinci robotic-assisted modified Soave operation for hirschsprung disease

目的分析并评估达芬奇机器人辅助改良Soave术治疗先天性巨结肠的临床疗效。方法回顾性分析2023年至2024年就诊于遵义医科大学附属医院行达芬奇机器人辅助手术治疗的14例先天性巨结肠患儿临床资料,其中女性5例,男性9例,分析患儿基本资料、手术参数、术后恢复、术后近期并发症及随访情况。结果14例行达芬奇机器人辅助改良Soave术患儿中位年龄6个月,体质量(10.7±5.9)kg,手术操作时间为(156.17±16.74)min,机器人控制台时间(60.01±8.18)min。术中出血量为(7.71±2.01)mL,术后胃管留置时间为(1.61±0.74)d,术后患儿经口进食时间为(1.78±0.69)d,术后留置肛管时间为(5.35±1.73)d,术后住院时间为(7.57±1.28)d,所有患儿术后无30 d非计划再次入院,随访时间(3.27±3.30)个月,术后近期无严重并发症发生(吻合口狭窄、肌鞘感染、吻合口瘘等),术后2例患儿并发小肠结肠炎。结论达芬奇机器人辅助改良Soave术治疗先天性巨结肠安全可行,也适合小婴儿、甚至低体重婴儿,盆底解剖更精准,肛门括约肌损伤减轻,同时能有效避免副损伤。

Objective To evaluate the clinical efficacy of Da Vinci robotic-assisted modified Soave operation for hirschsprung disease.Methods From 2023 to 2024,14 children with hirschsprung disease underwent Da Vinci robotic-assisted modified Soave operation in the Affiliated Hospital of Zunyi Medical University were retrospectively analyzed.There were 5 females and 9 males,and the basic information,operative parameters,postoperative recovery,recent postoperative complications,and follow-up of the patients were recorded.Results All of them underwent Da Vinci robotic-assisted modified Soave operation,with a median age at surgery of 6 months,the weight was(10.7±5.9)kg,the operative time was(156.17±16.74)min,robot control console time was(60.01±8.18)min,the intraoperative blood loss was(7.71±2.01)ml,the postoperative gastric tube-retention time was(1.61±0.74)d,the postoperative oral feeding time was(1.78±0.69)d,the postoperative anal tube retention time was(5.35±1.73)d,and the postoperative hospitalization time was(7.57±1.28)d.All patients had no unplanned readmission for 30 days after surgery,and the follow-up time was(3.27±3.30)months.There was no serious complications(such as anastomotic strictures,cuff infection,anastomotic leakage)in the recent postoperative period,two cases had postoperative enterocolitis.Conclusion Da Vinci robotic-assisted modified Soave operation is a safe and feasible alternative for the treatment of hirschsprung disease,which is suitable to infant,even low weight infants,with accurate pelvic floor anatomy,thus it would reduce injury to anal sphincter,and eliminate the risk of secondary injury.