达芬奇机器人手术系统在小儿肾上腺肿瘤切除手术中的应用

目的 探讨达芬奇机器人手术系统在小儿肾上腺肿瘤手术应用中的有效性及安全性.方法 回顾性分析2016年1月至2016年3月本院小儿外科完成的3例达芬奇机器人手术系统行小儿右侧肾上腺肿瘤切除术的临床资料.男1例,女2例,平均年龄为5.2岁(3岁5个月～9岁9个月),右侧3例;肿瘤大小为(2.0～3.6)cm×(1.0～3.6) cm.患儿术前均明确诊断肾上腺区占位,并完成影像学资料、血液学肿瘤标志物及儿茶酚胺定性分析等检查.记录患儿的手术时间、术中出血量、围手术期并发症等指标.结果 所有患儿均行一期肿瘤切除术,手术时间为90～120 min,术中出血20～50 ml,无中转腹腔镜和开腹病例;术后无特殊并发症及死亡病例发生.术后病检结果2例诊断为肾上腺节细胞神经瘤,1例为肾上腺节细胞神经母细胞瘤.总共住院时间为8～16 d.术后平均随访1年,复查CT无肿瘤复发,患儿生长发育良好.结论 达芬奇机器人手术系统在小儿肾上腺肿瘤切除手术中,能精确地解剖病灶并精准地进行手术操作,具有手术创伤小、术后恢复快等优势.我们的研究初步证实该术式安全、有效、具有可行性.

Preliminary experience of robotic-assisted laparoscopic adrenalectomy in children

Objective To introduce our initial clinical experience of robotic-assisted laparoscopic adrenalectomy in the treatment of children adrenal tumor and to evaluate its efficacy and safety.Methods Between January 2016 to May 2016,3 patients received intmperitoneal robotic-assisted laparoscopic adrenalectomy by the da Vinci robotic surgical system.The perioperative data were retrospectively collected and analyzed.Results All the robotic-assisted laparoscopic surgical procedures were successfully accomplished by the da Vinci robotic system without any conversion.The operative time was between 90-120 min and the median blood loss was 37 ml.Two cases were pathologically diagnosed as adrenal ganglioneuroma and one was ganglioneuroblastoma.During 12 months' follow-up,no tumor recurrence was observed by CT examination,the growth and development of all patients were well.Conclusions Robotic-assisted laparoscopic surgery using the da Vinci system is safe and feasible for the treatment of adrenal tumor in pediatric surgery.