机器人辅助与腹腔镜辅助儿童部分脾切除术的优势与局限性对比OA

Objective:To compare the clinical efficacy of robot-assisted partial splenectomy(RAPS)with laparoscopic partial splenectomy(LPS)in children with splenic diseases.Methods:A retrospective analysis was conducted on 37 pediatric patients who underwent partial splenectomy at the Department of Pediatric Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,from January 2013 to December 2024.Patients were divided into the RAPS group(n=16,receiving RAPS)and the LPS group(n=21,receiving LPS).Perioperative indicators including rate of conversion to open surgery,intraoperative complications,total operative time,time to dissect hilar vessels,time to transect splenic tissue,intraoperative blood loss,length of hospital stay,and hospitalization cost were compared between the two groups of patients.Postoperative follow-up indicators such as follow-up duration and complication rates were also statistically analyzed.Results:All procedures were successfully completed.Two cases in the LPS group required conversion to open surgery.There was no significant difference in median total operative time between the two groups(P＞0.05).However,the RAPS group has significantly shorter mean times for dissecting hilar vessels(P＜0.05),transecting splenic tissue(P＜0.001),and the combined time for both steps(P＜0.001).Median intraoperative blood loss was significantly lower in the RAPS group than that in the LPS group(P＜0.001).No statistically significant differences were observed in median length of hospital stay or overall postoperative complication rates(P＞0.05).Mean hospitalization cost was significantly higher in the RAPS group than that in the LPS group(P＜0.001).Conclusion:Robot-assisted surgery is an ideal choice for partial splenectomy due to its precision in dissecting splenic hilar vessels and accuracy in removing splenic tissues.Its primary advantages include less intraoperative blood loss,shorter time for separating the splenic hilar vessels and dissecting the splenic tissue,but it has the main limitation of higher hospitalization costs.