Total oesophago-gastric dissociation in neurologically impaired children: Laparoscopic vs robotic approach.


Journal

The international journal of medical robotics + computer assisted surgery : MRCAS
ISSN: 1478-596X
Titre abrégé: Int J Med Robot
Pays: England
ID NLM: 101250764

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 26 01 2019
revised: 24 09 2019
accepted: 07 10 2019
pubmed: 5 12 2019
medline: 24 11 2020
entrez: 5 12 2019
Statut: ppublish

Résumé

To evaluate and compare the feasibility and short-term results of laparoscopic and robotic total oesophago-gastric dissociation (TOGD) with a Roux-en-Y oesophago-jejunostomy. Minimal invasive surgery has multiple advantages in neurologically impaired patients. Robotic approach has overcome disadvantages linked to laparoscopy, in particular, referring to the surgeon fatigue. A retrospective study comparing five laparoscopic and five robotic TOGD was conducted between February and October 2016 in Giannina Gaslini Children's Hospital and Section of Pediatric Surgery of Siena. Neurologically impaired children scheduled for TOGD were included. Age, sex, weight, symptomatology, presence of epilepsy, and preoperative X-ray contrast were considered. Operative time, hospital stay, postoperative complications, redo surgery, nutrition rehabilitation, and X-ray contrast study after 5 days and after 1 month from the intervention were recorded. In our series, there were no intraoperative complications, no conversions to open surgery, and no vagal lesions. In two of five robotic cases, a pyloroplasty was necessary. The median operative time was statistically longer in the robotic group. One dehiscence in the robotic group was recorded, and no dumping episodes occurred. No statistical differences in terms of complications were detected. TOGD is feasible both with laparoscopic and robotic-assisted surgery with similar results. Robotic approach is considered feasible. At the same time, high laparoscopic skills allow to reach the same results as robotic approach with shorter operative time.

Identifiants

pubmed: 31797517
doi: 10.1002/rcs.2048
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e2048

Informations de copyright

© 2019 John Wiley & Sons, Ltd.

Références

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Auteurs

Girolamo Mattioli (G)

DINOGMI, University of Genoa, Genoa, Italy.
Paediatric Surgery Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Michela C Y Wong (MCY)

DINOGMI, University of Genoa, Genoa, Italy.
Paediatric Surgery Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Rossella Angotti (R)

Department of Medical Sciences, Surgery and Neuroscience, Section of Pediatric Surgery, University of Siena, Siena, Italy.

Cinzia Mazzola (C)

Paediatric Surgery Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Serena Arrigo (S)

Pediatric Gastroenterology Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Paolo Gandullia (P)

Pediatric Gastroenterology Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Margherita Mancardi (M)

Pediatric Neuromuscular Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Giulia Fusi (G)

Department of Medical Sciences, Surgery and Neuroscience, Section of Pediatric Surgery, University of Siena, Siena, Italy.

Mario Messina (M)

Department of Medical Sciences, Surgery and Neuroscience, Section of Pediatric Surgery, University of Siena, Siena, Italy.

Clelia Zanaboni (C)

Department of Pediatric Anesthesia, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Barbara Razore (B)

Paediatric Surgery Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Arrigo Barabino (A)

Pediatric Gastroenterology Unit, Giannina Gaslini Children's Hospital, Institute for Scientific Research, Genoa, Italy.

Francesco Molinaro (F)

Department of Medical Sciences, Surgery and Neuroscience, Section of Pediatric Surgery, University of Siena, Siena, Italy.

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