摘要
目的:探讨机器人辅助单孔腹腔镜手术(robot-assisted laparoendoscopic single-site surgery,RLESS)在小儿泌尿外科中的应用,并对R-LESS的单中心经验进行初步总结。方法:收集2024年2月—2025年5月在中山大学附属第六医院接受R-LESS的43例患儿的临床资料并进行分析,患儿中位年龄13.0(3.0,68.0)个月,其中肾盂成形术27例,输尿管膀胱再植术10例,发育不良肾切除术5例,肾上腺切除术联合脐尿管囊肿切除1例。结果:所有患儿均通过R-LESS顺利完成手术,无中转开腹,无术中并发症发生。中位住院天数6.0(5.0,10.0)d,术后中位住院天数3.0(2.0,5.0)d,中位随访8.7(3.4,10.8)个月。6例(13.9%)患儿出现术后并发症,其中4例(9.3%)患儿出现发热性泌尿道感染,经抗生素治疗后治愈;1例(2.3%)患儿拔除引流管出现大网膜脱出行还纳术;1例(2.3%)患儿因伤口愈合不良返院行清创术,术后伤口愈合良好。结论:对于经验丰富的中心,RLESS应用于小儿泌尿外科手术可行、安全、有效。
Objective:To explore the application of robot-assisted laparoendoscopic single-site surgery(RLESS)in pediatric urology,and summarize the single-center experience of R-LESS.Methods:The clinical data of 43children who underwent R-LESS from February 2024to May 2025were collected and analyzed.The median age of the children was 13.0(3.0,68.0)months.Among them,27cases underwent pyeloplasty,10cases underwent ureterovesical reimplantation,5cases underwent nephrectomy for dysplastic kidney,and 1case underwent adrenalectomy combined with urachal cyst resection.Results:All the patients were successfully operated by R-LESS,and no conversion to open surgery or intraoperative complications occurred.The median hospital stay was 6.0(5.0,10.0)days,the median postoperative hospital stay was 3.0(2.0,5.0)days,and the median follow-up was 8.7(3.4,10.8)months.Postoperative complications occurred in 6cases(13.9%).Febrile urinary tract infection occurred in 4cases(9.3%),and was cured after antibiotic treatment.Omental prolapse occurred in 1case(2.3%)after drainage tube removal and reduction was taken.One case(2.3%)returned to hospital for debridement due to poor wound healing,and the postoperative wound healing was good.Conclusion:In experienced centers,R-LESS is a feasible,safe,and effective approach for pediatric urological surgery.
作者
何子勤
李俊涛
张翼飞
肖楚天
赵阳杰
钟文文
叶雷
邱剑光
王德娟
HE Ziqin;LI Juntao;ZHANG Yifei;XIAO Chutian;ZHAO Yangjie;ZHONG Wenwen;YE Lei;QIU Jianguang;WANG Dejuan(Department of Pediatric Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,510655,China;Department of Urology,The Sixth Affiliated Hospital,Sun Yatsen University;Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University)
出处
《临床泌尿外科杂志》
2025年第11期983-987,共5页
Journal of Clinical Urology
关键词
机器人辅助单孔腹腔镜手术
小儿
泌尿外科
肾盂成形术
输尿管再植
robot-assisted single-port laparoendoscopic surgery
pediatric
urology
pyeloplasty
ureteral reimplantation
