隐藏切口在机器人辅助腹腔镜小儿根治性肾切除术中的应用

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.03.003

Lijun Zhou, Hua Xie, Fang Chen, Yi-Chen Huang, Yiqing Lyu, Yan Chen, Linhui Wang, Yinghao Sun

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引用次数: 0

摘要

目的探讨儿童机器人辅助腹腔镜根治性肾切除术中隐切口标本提取的价值。方法回顾性分析机器人辅助腹腔镜根治性肾切除术的临床资料。从2015年8月至2019年2月招募了6名接受机器人辅助腹腔镜根治性肾切除术的患者。男4例，女2例，平均年龄47个月。其中Wilms肿瘤3例，Xp11.2易位性肾细胞癌2例，后肾腺瘤1例。受累侧为左侧(n=3)和右侧(n=3)。目镜套管针放置于脐对侧缘，侧卧60°。手术孔1位于前中线上方6- 7cm处(视腹壁间隙而定)，手术孔2位于前中线与下横向Pfannenstiel切口相交处。套管针在皮下埋入，如有需要则插入腹腔(2号手术孔上方1.5 cm处)。在患侧下腹部横线处放置辅助孔套管针。所有患儿均行根治性切除。取出标本后放入标本袋。然后扩大下腹部横切口(切口长度等于最小肾径)。通过Pfannenstiel切口取出标本袋。结果3例应用辅助孔，平均切口长度6.5(5 ~ 8)cm。所有标本均完整提取。术后平均住院时间为4.5(4-7)天。术后创面无活动性出血、裂开或感染。平均随访25(4-46)个月，术后创面恢复良好，无瘢痕增生。结论隐式Pfannenstiel切口可安全有效地用于儿童机器人辅助腹腔镜根治性肾切除术标本提取。关键词:肾肿瘤;隐藏的切口;机器人辅助腹腔镜手术;孩子

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Application of hidden incision for specimen extraction during robot-assisted laparoscopic pediatric radical nephrectomy

Objective To explore the value of hidden incision for specimen extraction during pediatric robot-assisted laparoscopic radical nephrectomy. Methods The clinical data of robotic-assisted laparoscopic radical nephrectomy were retrospectively analyzed. Six patients undergoing robot-assisted laparoscopic radical nephrectomy were recruited from August 2015 to February 2019. There were 4 boys and 2 girls with a mean age of 47 months. There were Wilms' tumor (n=3), Xp11.2 translocation renal cell carcinoma (n=2) and metanephric adenoma (n=1). The involved side was left (n=3) and right (n=3). With a 60° lateral position, eyepiece Trocar was located at umbilical contralateral margin. The operation hole 1 was located at 6-7 cm above anterior median line (depending upon abdominal wall space) and operation hole 2 at the intersection of anterior median line and lower transverse Pfannenstiel incision. Trocar was sneaked under skin and then inserted into abdominal cavity (1.5 cm above operation hole 2) if auxiliary hole was needed. Auxiliary hole Trocar was placed on the affected side of lower abdominal transverse line. All children underwent radical resection. After removal, specimen was placed into a specimen bag. Then lower abdominal transverse incision (length of incision equal to the minimal renal diameter) was extended. The specimen bag was extracted through the Pfannenstiel incision. Results Auxiliary hole was applied in 3 cases with an average length of incision at 6.5(5-8) cm. All specimens were intactly extracted. The average postoperative hospital stay was 4.5(4-7) days. No active bleeding, splitting or infection of wounds occurred postoperatively. During an average follow-up period of 25(4-46) months, postoperative wound recovery was excellent and there was no scar hyperplasia. Conclusions The hidden Pfannenstiel incision may be safely and effectively applied for specimen extraction during pediatric robot-assisted laparoscopic radical nephrectomy. Key words: Kidney neoplasms; Hidden incision; Robot assisted laparoscopic surgery; Child

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.