دورية أكاديمية
أعرض في EDS

Robotic-assisted vs. Laparoscopic Heller's Myotomy for Achalasia in Children.

التفاصيل البيبلوغرافية
العنوان: Robotic-assisted vs. Laparoscopic Heller's Myotomy for Achalasia in Children.
المؤلفون: Delgado-Miguel C; Department of Pediatric Surgery, Prisma Health Children's Hospital, Columbia, SC, USA; Institute for Health Research IdiPAZ, La Paz University Hospital, Madrid, Spain. Electronic address: carlosdelgado84@hotmail.com., Amarnath RP; Department of Pediatric Gastroenterology, Prisma Health Children's Hospital, Columbia, SC, USA., Camps JI; Department of Pediatric Surgery, Prisma Health Children's Hospital, Columbia, SC, USA.
المصدر: Journal of pediatric surgery [J Pediatr Surg] 2024 Jun; Vol. 59 (6), pp. 1072-1076. Date of Electronic Publication: 2023 Nov 10.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Saunders
Original Publication: New York.
مواضيع طبية MeSH: Esophageal Achalasia*/surgery , Heller Myotomy*/methods , Heller Myotomy*/economics , Heller Myotomy*/adverse effects , Robotic Surgical Procedures*/economics , Robotic Surgical Procedures*/methods , Laparoscopy*/methods , Laparoscopy*/economics , Length of Stay*/statistics & numerical data , Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Operative Time*, Humans ; Retrospective Studies ; Male ; Female ; Child ; Treatment Outcome ; Child, Preschool ; Adolescent ; Blood Loss, Surgical/statistics & numerical data
مستخلص: Introduction: Robotic-assisted Heller-Dor procedure has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia in children. Our aim is to compare the effectiveness, safety and associated costs between both procedures.
Methods: A retrospective single center study was conducted among consecutive children operated for achalasia (Heller-Dor operation) between 2005 and 2021, who were divided into two groups according to the surgical approach: laparoscopic (LAP-group) or robotic (ROB-group). Demographics, clinical features, surgery time, length of hospital stay (LOS), postoperative complications, long-term outcomes and economic data were compared between both groups.
Results: A total of 24 patients were included (12 in LAP-group; 12 in ROB-group), with no demographic or clinical differences between them. ROB-group patients presented lower intraoperative blood loss (23 ± 15 vs. 95 ± 15 ml; p < 0.001), shorter surgery time (178 ± 25 vs. 239 ± 55 min; p = 0.009) and shorter LOS, with a median of 2 days (Q1-Q3: 2-3) when compared to LAP-group (4 days [Q1-Q3:3-5]; p = 0.008). Three post-operative complications were reported, all in LAP-group (2 esophageal perforations and 1 esophageal tightness). After a median follow-up of 11 years, ROB-group patients presented fewer recurrences (0 vs 5; p = 0.039), less reintervention rate (0 % vs 41.7 %; p < 0.039) and lower associated economic costs (28,660$ vs. 60,360$; p < 0.001).
Conclusion: This is the first comparative study of robotic and laparoscopic treatment of achalasia in children. Initial outcomes of robotic-assisted Heller-Dor procedure suggests some intraoperative (less blood loss and surgical time) and postoperative advantages (fewer complications and reinterventions). However, long-term studies with larger numbers of patients are needed.
Type of Study: Retrospective comparative study.
Level of Evidence: III.
Competing Interests: Conflicts of interest The authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Achalasia; Children; Heller's myotomy; Robot-assisted; Robotics
تواريخ الأحداث: Date Created: 20231128 Date Completed: 20240520 Latest Revision: 20240520
رمز التحديث: 20240521
DOI: 10.1016/j.jpedsurg.2023.11.003
PMID: 38016851
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-5037
DOI:10.1016/j.jpedsurg.2023.11.003