达芬奇机器人手术与传统开腹手术治疗胆道闭锁的早期疗效对比.

Objective To compare the early efficacy and safety of Da Vinci robot-assisted Kasai versus traditional open surgery for biliary atresia (BA). Methods From January 2021 to June 2022, retrospective analysis was performed for 9 children undergoing robotic portoenterostomy (RP) and another 21 children open portoenterostomy (OP) within the same period. General profiles, perioperative biochemical parameters, postoperative complications and hospitalization stay were compared. Results In RP group, there were 8 boys and 1 girl with a body weight of 5.4(5.0-6.5) kg and an average age of 65(56-90) day; In OP group, 13 boys and 8 girls with a body weight of 4.9 (4.5-5.8) kg and an average age of 59(49, 85) day. No significant differences existed among the above parameters (P>0.05). In RP and OP groups, preoperative total bilirubin [179.6(116.2-224.5) mmol/L vs. 170.3(129.6-208.2) mmol/L], postoperative total bilirubin [115.0(69.3-143.4) mmol/L vs. 120.3(88.5-160.7) mmol/L], preoperative direct bilirubin[83.4(79.0-155.7) mmol/L vs. 97.6(82.5-147.4) mmol/L], postoperative direct bilirubin [71.6(47.6-100.2) mmol/L vs. 82.1(64.3-117.5) mmol/L], preoperative alanine aminotransferase [175(114-234) U/L vs. 147(94-218) U/L], postoperative alanine aminotransferase [144(119-310) U/L vs. 183(150-253) U/L], preoperative aspartate aminotransferase [212(164-164) U/L vs. 129 (96-157) U/L] and postoperative aspartate aminotransferase [167(90-191) U/L vs. 120 (80-155) U/L]. There were no differences of statistical significance (P>0.05). Compared with those before operation, the biochemical indexes of children in all groups after operation were decreased except for the increase of alanine aminotransferase after operation in OP group, with statistical significance (P < 0.05). Postoperative hospitalization stay [15(12.5-21.5) day vs. 15(12-17.5) day], postoperative complication rate (2/9 vs. 3/21), cholangitis rate (7/9 vs. 15/21) and jaundice clearance (3/9 vs. 12/21) showed no inter-group differences of statistical significance (P>0.05). Conclusions Early curative efficacy of Da Vinci robotic surgery and open surgery is comparable for BA. [ABSTRACT FROM AUTHOR]