摘要
目的总结机器人辅助腔镜技术在小儿膈肌内隔离肺手术治疗中的应用经验。方法回顾性分析2020年5月至2022年8月浙江大学医学院附属儿童医院收治的10例膈肌内隔离肺患儿临床资料,其中男4例、女6例,年龄6个月至5岁,中位年龄11个月,体重(10.97±3.07)kg。除2例为体检偶然发现外,其余8例均于产前胎儿超声检查过程中发现。10例隔离肺均位于左侧膈肌内,术前胸部增强CT检查均发现腹主动脉分支供血的膈肌内异常软组织,考虑为膈肌内隔离肺,收集所有患儿手术情况及治疗结果。结果10例均经机器人辅助腔镜手术治愈。其中经胸手术8例,经腹手术2例,手术时间(91.50±31.18)min,术中均证实隔离肺位于膈肌内,予切开部分膈肌,结扎滋养血管后取出病灶,缝合膈肌组织。术后住院时间(4.30±1.06)d,均获随访(随访时间1~6个月),均生长发育良好。结论手术切除是膈肌内隔离肺的主要治疗方法,经胸操作是首选,机器人手术系统用于儿童膈肌内隔离肺手术安全可行。
Objective To explore the application of robot-assisted endoscopic surgery for intradiaphragmatic pulmonary sequestration(IDPS)in children.Methods Clinical data were retrospectively reviewed for 10 IDPS children admitted into Children's Hospital of Zhejiang University School of Medicine from May 2020 to August 2022.There were 4 boys and 6 girls with a median age of 11(6-60)month and an average weight of(10.97±3.07)(7.4-16.6)kg.Except for 2 cases accidentally spotted by physical examination,the other 8 cases were detected by prenatal fetal ultrasound.All lesions were located in left diaphragm.Enhanced chest computed tomography(CT)revealed abnormal soft tissue in diaphragm supplied by the branches of abdominal aorta.Results All procedures were successfully completed by robot-assisted endoscopic system.The routes were transthoracic(n=8)and transabdominal(n=2).The average operative duration was(91.50±31.18)(60-150)min.After a partial incision of diaphragm and a ligation of nutrient vessels,diaphragmatic tissue was sutured.No operative mortality occurred.The average postoperative hospitalization time was(4.30±1.06)(2-5)day.All of them recovered well during a follow-up period of(1-6)month.Conclusion The incidence of IDPS is low.Transthoracic resection is a major option.And robotic surgical system is both safe and feasible for IDPS in children.
作者
梁靓
谭征
黄婷
高跃
章坚
俞建根
Liang Liang;Tan Zheng;Huang Ting;Gao Yue;Zhang Jian;Yu Jiangen(Department of Thoracic Surgery,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Children's Health,Hangzhou 310052,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2023年第10期971-976,共6页
Journal of Clinical Pediatric Surgery
关键词
支气管肺隔离症
机器人手术
胸腔镜检查
治疗结果
儿童
Bronchopulmonary Sequestration
Robotic Surgical Procedures
Thoracoscopy
Treatment Outcome
Child
