Robot-assisted thoracoscopic plication for diaphragmatic eventration
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: Though conventional thoracoscopic plication is a favorable option of diaphragmatic eventration (DE), ribs limited the movement of trocars, making it difficult to suturing, knot-tying and time-consuming. The purpose of this study was to evaluate delicate surgical maneuvers and suturing time for the management of DE in robot-assisted thoracoscopic plication (RATP).
METHODS: From January 2015 to November 2019, 20 patients (14 males; mean age: 10.5 ± 5.2 months; mean weight: 8.6 ± 4.5 kg) who underwent diaphragmatic plication for DE were reviewed at our institution. There were 13 patients with congenital diaphragmatic eventration and 7 patients with acquired diaphragm eventration after congenital heart surgery. RATP was performed on 9 patients (3 on the left and 6 on the right), and conventional thoracoscopic plication (CTP) was applied to 11 patients (5 on the left and 6 on the right). Demographics, the suturing time and complications were respectively evaluated.
RESULTS: There was no difference between 2 groups with respect to gender, age at surgery and weight (p > 0.05). No conversion to thoracotomy was needed. The suturing time in RATP group was shorter than CTP group (27.7 ± 3.4 min vs 48.1 ± 4.2 min, p < 0.001). One patient (9.09%) experienced recurrence in CTP group and none was found in RATP group.
CONCLUSIONS: Diaphragmatic plication with robot-assisted thoracoscopy or conventional thoracoscopy in DE has minimally invasive and good effect on children. RATP overcome the intercostal limitations to complete delicate suturing and free knot-tying, and has better ergonomics.
LEVEL OF EVIDENCE: Level III.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
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| Enthalten in: |
Journal of pediatric surgery - 55(2020), 12 vom: 23. Dez., Seite 2787-2790 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Xu, Pei-Pei [VerfasserIn] |
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| Links: |
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| Themen: |
Diaphragmatic eventration |
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| Anmerkungen: |
Date Completed 26.05.2021 Date Revised 26.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jpedsurg.2020.06.034 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31287877X |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Though conventional thoracoscopic plication is a favorable option of diaphragmatic eventration (DE), ribs limited the movement of trocars, making it difficult to suturing, knot-tying and time-consuming. The purpose of this study was to evaluate delicate surgical maneuvers and suturing time for the management of DE in robot-assisted thoracoscopic plication (RATP) | ||
| 520 | |a METHODS: From January 2015 to November 2019, 20 patients (14 males; mean age: 10.5 ± 5.2 months; mean weight: 8.6 ± 4.5 kg) who underwent diaphragmatic plication for DE were reviewed at our institution. There were 13 patients with congenital diaphragmatic eventration and 7 patients with acquired diaphragm eventration after congenital heart surgery. RATP was performed on 9 patients (3 on the left and 6 on the right), and conventional thoracoscopic plication (CTP) was applied to 11 patients (5 on the left and 6 on the right). Demographics, the suturing time and complications were respectively evaluated | ||
| 520 | |a RESULTS: There was no difference between 2 groups with respect to gender, age at surgery and weight (p > 0.05). No conversion to thoracotomy was needed. The suturing time in RATP group was shorter than CTP group (27.7 ± 3.4 min vs 48.1 ± 4.2 min, p < 0.001). One patient (9.09%) experienced recurrence in CTP group and none was found in RATP group | ||
| 520 | |a CONCLUSIONS: Diaphragmatic plication with robot-assisted thoracoscopy or conventional thoracoscopy in DE has minimally invasive and good effect on children. RATP overcome the intercostal limitations to complete delicate suturing and free knot-tying, and has better ergonomics | ||
| 520 | |a LEVEL OF EVIDENCE: Level III | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diaphragmatic eventration | |
| 650 | 4 | |a Knot-tying | |
| 650 | 4 | |a Robot-assisted thoracoscopic plication | |
| 650 | 4 | |a Suturing | |
| 650 | 4 | |a Thoracoscopic plication | |
| 700 | 1 | |a Chang, Xiao-Pan |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Shao-Tao |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Shuai |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Guo-Qing |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xi |e verfasserin |4 aut | |
| 700 | 1 | |a Chi, Shui-Qing |e verfasserin |4 aut | |
| 700 | 1 | |a Fang, Mi-Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, De-Hua |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Xiang-Yang |e verfasserin |4 aut | |
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