[1]李帅 李康 郑芳① 雷萍② 杨德华 曹国庆 毛永忠 王勇 汤绍涛*.机器人胸腔镜解剖性肺段切除术治疗小儿肺疾病: 5例报告[J].中国微创外科杂志,2023,01(1):66-70.
　Li Shuai*,Li Kang*,Zheng Fang,et al.Robotassisted Thoracoscopic Anatomic Segmentectomy in Children With Pulmonary Anomaly：a Report of 5 Cases[J].Chinese Journal of Minimally Invasive Surgery,2023,01(1):66-70.
点击复制

机器人胸腔镜解剖性肺段切除术治疗小儿肺疾病: 5例报告()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年1期
页码:
66-70
栏目:
经验交流
出版日期:
2023-01-25

文章信息/Info

Title:
Robotassisted Thoracoscopic Anatomic Segmentectomy in Children With Pulmonary Anomaly：a Report of 5 Cases
作者:
李帅 李康 郑芳① 雷萍② 杨德华 曹国庆 毛永忠 王勇 汤绍涛*
(华中科技大学同济医学院附属协和医院小儿外科，武汉430022)
Author(s):
Li Shuai*;  Li Kang*;  Zheng Fang;  et al.
*Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
关键词:
胸腔镜; 肺段切除术; 机器人手术; 小儿
Keywords:
Thoracoscope; Pulmonary segmentectomy; Robotic surgery; Pediatrics
文献标志码:
B
摘要:
目的探讨机器人胸腔镜解剖性肺段切除术治疗小儿肺疾病的安全性。方法2020年1月~2021年12月我们对5例小儿肺疾病采用三臂四孔法，在机器人辅助胸腔镜下解剖并处理肺段级动脉、静脉及支气管，精准切除病变。结果5例均顺利完成手术，无中转开放手术。连机时间平均17.8 min(12~23 min)，机器人手术时间平均134.0 min(60~180 min)，术中出血量平均25.0 ml(5~50 ml)，胸管保留时间平均2.0 d(1~3 d)，术后住院时间平均6.8 d(5~9 d)。1例无症状性气胸，无胸腔积液、肺部感染、病灶残留等并发症。5例随访时间9~19个月，平均13个月，无胸腔积液、肺部感染、病灶残留等并发症。结论机器人应用于10 kg以上体重的小儿解剖性肺段切除术是安全可行的。
Abstract:
ObjectiveTo explore the safety of robotic thoracoscopic anatomical segmentectomy for congenital pulmonary anomalies in children.MethodsFrom January 2020 to December 2021, we dissected the segmental pulmonary arteries, veins and bronchi under the robotassisted thoracoscope so as to accurately removed the lesions, by using the “three arms, four ports” technique.ResultsAll the operations were successfully completed in the 5 patients, and there was no conversion to open surgery. The docking time was 17.8 min (range, 12-23 min), the average robot operation time was 134.0 min (range, 60-180 min), and the average intraoperative bleeding was about 25.0 ml (range, 5-50 ml). The chest tube duration time was 2.0 d (range, 1-3 d), and the postoperative hospital stay was 6.8 d (range, 5-9 d). One case got asymptomatic pneumothorax without pleural effusion, pulmonary infection or residual lesions. All the 5 patients were followed up for 9-19 months (mean, 13 months) and there were no complications such as pleural effusion, pulmonary infection or residual lesions.ConclusionIt is safe and feasible to apply robot for anatomical segmentectomy in children weighing more than 10 kg.

参考文献/References:

[1]Wong KKY, Flake AW, Tibboel D, et al. Congenital pulmonary airway malformation: advances and controversies. Lancet Child Adolesc Health,2018,2(4):290-297.
[2]Rothenberg SS, Shipman K, Kay S, et al. Thoracoscopic segmentectomy for congenital and acquired pulmonary disease: a case for lungsparing surgery. J Laparoendosc Adv Surg Tech A,2014,24(1):50-54.
[3]Meehan JJ, Phearman L, Sandler A. Robotic pulmonary resections in children: series report and introduction of a new robotic instrument. J Laparoendosc Adv Surg Tech A,2008,18(2):293-295.
[4]李帅,汤绍涛,曹国庆,等.da Vinci机器人辅助胸腔镜下小儿肺叶切除术的初步经验.临床小儿外科杂志,2020,19(7):619-621,647.
[5]谭征,俞建根,梁靓等.机器人辅助胸腔镜技术治疗小儿先天性肺部疾病的单中心研究.临床小儿外科杂志,2021,20(8):708-711.
[6]李帅, 冯建军, 雷海等.儿童硬化性肺泡细胞瘤行机器人胸腔镜解剖性肺段切除术一例报道.机器人外科学杂志(中英文),2022,3(1):72-76.
[7]Lee S, Kim DH, Lee SK. Efficacy of segmental resection in patients with prenatally diagnosed congenital lung malformations. Interact Cardiovasc Thorac Surg,2017,24(3):425-429.
[8]程凯昇, 袁淼, 徐畅,等.胸腔镜解剖性肺段切除治疗儿童先天性肺疾病临床分析.四川大学学报：医学版,2019,50(4):594-597.
[9]Ballouhey Q, Villemagne T, Cros J, et al. Assessment of paediatric thoracic robotic surgery. Interact Cardiovasc Thorac Surg,2015,20(3):300-303.
[10]Koga H, Nakamura H, Murakami H, et al. Thoracoscopic pulmonary lobectomy for densely fused pulmonary lobes in children with congenital pulmonary airway malformation: Technical tips. J Laparoendosc Adv Surg Tech A,2019,29(3):415-419.
[11]Rothenberg SS, Middlesworth W, KadennheChiweshe A, et al. Two decades of experience with thoracoscopic lobectomy in infants and children: standardizing techniques for advanced thoracoscopic surgery. J Laparoendosc Adv Surg Tech A,2015,25(5):423-428.
[12]Yamataka A, Koga H, Ochi T, et al. Pulmonary lobectomy techniques in infants and children. Pediatr Surg Int,2017,33(4):483-495.
[13]陈醒狮,金润森.肺段切除术中段间平面处理方式的研究进展.中国微创外科杂志,2019,19(2):190-192.
[14]邵丰,孙云刚,王朝,等.荧光法与膨胀萎陷法在胸腔镜解剖性肺段切除术中界定段间平面的对照研究.中国胸心血管外科临床杂志,2019,26(9):899-904.
[15]李帅,黄格元,汤绍涛.胸腔镜解剖性肺段切除治疗先天性肺气道畸形国内外研究现状.中华小儿外科杂志,2021,42(2):177-180.
[16]Stanton M, Njere I, AdeAjayi N, et al. Systematic review and metaanalysis of the postnatal management of congenital cystic lung lesions. J Pediatr Surg,2009,44(5):1027-1033.
[17]Johnson SM, Grace N, Edwards MJ, et al. Thoracoscopic segmentectomy for treatment of congenital lung malformations. J Pediatr Surg,2011,46(12):2265-2269.
[18]Komori K, Kamagata S, Hirobe S, et al. Radionuclide imaging study of longterm pulmonary function after lobectomy in children with congenital cystic lung disease. J Pediatr Surg,2009,44(11):2096-2100.
[19]Sritippayawan S, Treerojanapon S, Sanguanrungsirikul S, et al. Pulmonary function and exercise capacity in children following lung resection surgery. Pediatr Surg Int,2012,28(12):1183-1188.
[20]Lau CT, Wong KKY. Longterm pulmonary function after lobectomy for congenital pulmonary airway malformation: is thoracoscopic approach really better than open? J Pediatr Surg,2018,53(12):2383-2385.

备注/Memo

备注/Memo:
*汤绍涛通讯作者，Email:tshaotao83@126.com ①儿科 ②放射科
更新日期/Last Update: 2023-04-23