{"title":"在胆道闭锁患者中比较机器人辅助卡萨伊肠管造口术和开放式卡萨伊肠管造口术。","authors":"Yu Guo, Jing-Feng Tang, Xi Zhang, Meng-Xin Zhang, Guo-Qing Cao, Shui-Qing Chi, Yun Zhou, Shao-Tao Tang","doi":"10.1007/s00464-024-11385-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted Kasai portoenterostomy (RAKPE) is regarded as a treatment option for patients with biliary atresia (BA). We aimed to compare the clinical outcomes of RAKPE to the open Kasai portoenterostomy (OKPE).</p><p><strong>Methods: </strong>A retrospective review was conducted on a total of 74 type III BA patients who underwent RAKPE (RA group, n = 36) or OKPE (OP group, n = 38) from January 2018 to December 2022. The study analyzed demographic characteristics, intraoperative findings, and postoperative outcomes.</p><p><strong>Results: </strong>The operative time in the RA group was significantly longer than that in the OP group (218.61 ± 31.70 min vs 178.50 ± 27.90 min, P < 0.05). The estimated blood loss in RA group was significantly lower than that in the OP group (8.65 ± 2.30 mL vs 17.55 ± 3.60 mL, P < 0.05). The recovery time of bowel sounds was significantly shorter in RA group than in the OP group (0.96 ± 0.12 days vs 2.84 ± 0.37 days, P < 0.05). All patients had bile-stained stools within 1-3 days after surgery. The clearance rate of jaundice at 3 and 6 months were significantly higher in RA group than in OP group (69.44% vs 60.53%, 75.00% vs 68.42%, P < 0.05). The rate of cholangitis in RA group was similar to that in OP group (50.00% vs 52.63%, P > 0.05). The native liver survival rate during the follow-up period was comparable between two groups (66.67% vs 63.16%, P > 0.05).</p><p><strong>Conclusion: </strong>Robotic-assisted Kasai surgery offers advantages in short-term outcomes and the clearance of jaundice in patients with type III BA.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison between robotic-assisted Kasai portoenterostomy and open Kasai portoenterostomy in patients with biliary atresia.\",\"authors\":\"Yu Guo, Jing-Feng Tang, Xi Zhang, Meng-Xin Zhang, Guo-Qing Cao, Shui-Qing Chi, Yun Zhou, Shao-Tao Tang\",\"doi\":\"10.1007/s00464-024-11385-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Robotic-assisted Kasai portoenterostomy (RAKPE) is regarded as a treatment option for patients with biliary atresia (BA). We aimed to compare the clinical outcomes of RAKPE to the open Kasai portoenterostomy (OKPE).</p><p><strong>Methods: </strong>A retrospective review was conducted on a total of 74 type III BA patients who underwent RAKPE (RA group, n = 36) or OKPE (OP group, n = 38) from January 2018 to December 2022. The study analyzed demographic characteristics, intraoperative findings, and postoperative outcomes.</p><p><strong>Results: </strong>The operative time in the RA group was significantly longer than that in the OP group (218.61 ± 31.70 min vs 178.50 ± 27.90 min, P < 0.05). The estimated blood loss in RA group was significantly lower than that in the OP group (8.65 ± 2.30 mL vs 17.55 ± 3.60 mL, P < 0.05). The recovery time of bowel sounds was significantly shorter in RA group than in the OP group (0.96 ± 0.12 days vs 2.84 ± 0.37 days, P < 0.05). All patients had bile-stained stools within 1-3 days after surgery. The clearance rate of jaundice at 3 and 6 months were significantly higher in RA group than in OP group (69.44% vs 60.53%, 75.00% vs 68.42%, P < 0.05). The rate of cholangitis in RA group was similar to that in OP group (50.00% vs 52.63%, P > 0.05). The native liver survival rate during the follow-up period was comparable between two groups (66.67% vs 63.16%, P > 0.05).</p><p><strong>Conclusion: </strong>Robotic-assisted Kasai surgery offers advantages in short-term outcomes and the clearance of jaundice in patients with type III BA.</p>\",\"PeriodicalId\":22174,\"journal\":{\"name\":\"Surgical Endoscopy And Other Interventional Techniques\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgical Endoscopy And Other Interventional Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00464-024-11385-7\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Endoscopy And Other Interventional Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00464-024-11385-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：机器人辅助葛西肠管造口术（RAKPE）被认为是胆道闭锁（BA）患者的一种治疗选择。我们旨在比较 RAKPE 与开放式葛西肠管造口术（OKPE）的临床效果：我们对2018年1月至2022年12月期间接受RAKPE（RA组，n = 36）或OKPE（OP组，n = 38）治疗的74例III型BA患者进行了回顾性研究。研究分析了人口统计学特征、术中发现和术后结果：结果：RA组的手术时间明显长于OP组（218.61±31.70 min vs 178.50±27.90 min，P 0.05）。两组随访期间的原肝存活率相当（66.67% vs 63.16%，P > 0.05）：结论：机器人辅助 Kasai 手术在短期疗效和清除 III 型 BA 患者黄疸方面具有优势。
Comparison between robotic-assisted Kasai portoenterostomy and open Kasai portoenterostomy in patients with biliary atresia.
Background: Robotic-assisted Kasai portoenterostomy (RAKPE) is regarded as a treatment option for patients with biliary atresia (BA). We aimed to compare the clinical outcomes of RAKPE to the open Kasai portoenterostomy (OKPE).
Methods: A retrospective review was conducted on a total of 74 type III BA patients who underwent RAKPE (RA group, n = 36) or OKPE (OP group, n = 38) from January 2018 to December 2022. The study analyzed demographic characteristics, intraoperative findings, and postoperative outcomes.
Results: The operative time in the RA group was significantly longer than that in the OP group (218.61 ± 31.70 min vs 178.50 ± 27.90 min, P < 0.05). The estimated blood loss in RA group was significantly lower than that in the OP group (8.65 ± 2.30 mL vs 17.55 ± 3.60 mL, P < 0.05). The recovery time of bowel sounds was significantly shorter in RA group than in the OP group (0.96 ± 0.12 days vs 2.84 ± 0.37 days, P < 0.05). All patients had bile-stained stools within 1-3 days after surgery. The clearance rate of jaundice at 3 and 6 months were significantly higher in RA group than in OP group (69.44% vs 60.53%, 75.00% vs 68.42%, P < 0.05). The rate of cholangitis in RA group was similar to that in OP group (50.00% vs 52.63%, P > 0.05). The native liver survival rate during the follow-up period was comparable between two groups (66.67% vs 63.16%, P > 0.05).
Conclusion: Robotic-assisted Kasai surgery offers advantages in short-term outcomes and the clearance of jaundice in patients with type III BA.
期刊介绍：
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery
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