Abstract
Background
This study aimed to report our experience with a robot-assisted resection of choledochal cysts (CCs) in pediatric patients, especially focusing on changes in outcomes and operative trends.
Methods
We retrospectively reviewed medical records of all 158 patients under 18 years of age who underwent robot-assisted resection of CC in a single tertiary center between July 2008 and January 2021. Patients were divided into the first period (P1, July 2008–March 2016; N = 79) and second period (P2, April 2016–January 2021; N = 79) with equal number of participants. The patients of P2 were compared with those of P1 to assess clinical outcomes with operative details. Operative characteristics and postoperative prognosis were compared for each group.
Results
The mean operative time was 383.6 min for the P2 group and 462.6 min for the P1 group (p < 0.001). The mean estimated blood loss was 28 mL in the P2 group and 63 mL in the P1 group (p = 0.025). The rate of emergency department visit after the operation was lower in the P2 group (3.8% vs. 13.9%, respectively, p = 0.047). The two groups showed no significant differences in the rate of late postoperative complications and reoperations.
Conclusion
With the increase in the center’s experience, robot-assisted resection of CC can be safely adopted and feasible, especially for pediatric patients.
Levels of evidence
Treatment Study, Level III.
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Acknowledgements
The authors thank Medical Illustration & Design, part of the Medical Research Support Services of Yonsei University College of Medicine, for all artistic support related to this work.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Kyong Ihn, In Geol Ho, Young Ju Hong, Ho Jong Jeon, Dongeun Lee and Seok Joo Han have no have no relevant financial conflicts of interest to disclose.
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Ihn, K., Ho, I.G., Hong, Y.J. et al. Changes in outcomes and operative trends with pediatric robot-assisted resection of choledochal cyst. Surg Endosc 36, 2697–2704 (2022). https://doi.org/10.1007/s00464-021-08844-w
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DOI: https://doi.org/10.1007/s00464-021-08844-w