【摘要】 目的分析采用达芬奇机器人完成肾盂成形术患儿的临床资料,总结治疗经验,为深入开展儿童机器人手术提供参考。方法 2015年8月至2016年2月华中科技大学同济医学院附属同济医院小儿外科采用达芬奇机器人完成9例儿童肾盂成形术。其中男童8例,女童1例。平均年龄7. 6岁。回顾性分析患儿的临床资料,随访治疗效果。结果 9例患儿中4例为单纯肾盂输尿管连接部狭窄,2例为肾盂输尿管连接部息肉,1例为迷走血管压迫输尿管起始部,2例为一期肾盂成形术后再狭窄梗阻病例。所有患儿顺利完成手术,无中转开腹病例。平均手术时间为162 min,手术时间最长的1例为再次手术患儿,手术时间为213 min,最短1例手术时间为106 min。术后平均住院时间为8. 7 d,术后随访15～27个月,无肾积水复发或伤口感染等并发症出现。结论机器人操作灵活,缝合精细,学习曲线更短。但与腹腔镜手术相比,机器人手术也具有费用高,Trocar孔径大等缺点。在严格把握适应证的情况下,机器人手术将是治疗小儿泌尿外科疾病的有效方法。更多还原

【Abstract】 Objective To analyze our preliminary data on robotic-assisted procedures in pediatric urology so as to provide rationales for future robotic-assisted procedures in pediatric urology. Methods From August 2015 to February 2016,9 pediatric patients underwent robotic-assisted laparoscopic pyeloplasty. There were8 boys and 1 girl with a mean age of 7. 6( 5. 1-13. 1) years. Clinical data was retrospectively analyzed. Results All 9 procedures were successfully completed without a conversion into open surgery. The average operative duration was 162( 106-213) min. The causes were ureteropelvic junction stricture( n = 4),ureteropelvic junction polyp( n = 2),compression of aberrant renal vessel( n = 1) and recurrent ureteropelvic junction stricture after initial operation( n = 2). The average length of postoperative hospital stay was 8. 7 days and the duration of postoperative follow-up period 15-27 months. So far,no complication has been noticed. Conclusion A robot can achieve flexible handling,finer suture and easier learning. However,in comparison with laparoscopy,robotic-assisted surgery also has such disadvantages as a higher cost and larger Trocar. If its indications are strictly controlled,robotic-assisted surgery is an effective solution for pediatric pyeloplasty.更多还原