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Total versus conventional robotic-assisted cyst excisions and hepaticojejunostomies in children with choledochal cysts: a case–control study

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Abstract

The current study’s primary aim is to compare the safety and effectiveness between total and conventional robot-assisted cyst excisions and hepaticojejunostomies in children with choledochal cysts (CCs). Patients suffering from CCs treated with either total or conventional robot-assisted procedures (TRAS or CRAS) between December 2019 and February 2021 were analyzed retrospectively. Data collected included the characteristics, operative and postoperative details. The risk factors for conversion of TRAS to CRAS were analyzed by logistic regression analysis. There were 50 patients who underwent TRAS and CRAS, respectively, and 19 patients were transferred to CRAS. The operation time in the TRAS group was significantly higher than that of the CRAS group, while the time to taking water and hospital stay were significantly shorter (p < 0.05). No significant difference was observed in complications between the groups (p = 0.325). The risk factors for conversion of TRAS to CRAS were age ≥ 48 months, thickness of abdominal wall (TAW) ≥ 1.3 cm and upper abdominal length (UAL) ≥ 9.5 cm. Both TRAS and CRAS are safe and feasible. Performing TRAS is recommended for patients whose age ≥ 48 months, TAW ≥ 1.3 cm and UAL ≥ 9.5 cm, while for others, it is recommended to perform CRAS.

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Acknowledgements

We are very grateful for the support of Key R & D project of Sichuan Science and Technology Department (2021YFQ0063), and 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (Project no. ZYJC18003 & 2021HXFH020).

Funding

This work was supported by Key R & D project of Sichuan Science and Technology Department (2021YFQ0063), and 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (Project no. ZYJC18003 & 2021HXFH020).

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Authors and Affiliations

  1. Department of Pediatric Surgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan Province, China

    Xiaolong Xie, Kewei Li & Bo Xiang

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  1. Xiaolong Xie
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  2. Kewei Li
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  3. Bo Xiang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by XX, KL and BX. The first draft of the manuscript was written by XX and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kewei Li or Bo Xiang.

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Conflict of interest

All the authors (Xiaolong Xie, Kewei Li and Bo Xiang) have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the ethics committees of the West China Hospital of Sichuan University (Date 2021.10.25 /No.1519).

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Written informed consent was obtained from the parents.

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Xie, X., Li, K. & Xiang, B. Total versus conventional robotic-assisted cyst excisions and hepaticojejunostomies in children with choledochal cysts: a case–control study. J Robotic Surg 17, 869–876 (2023). https://doi.org/10.1007/s11701-022-01484-9

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  • DOI: https://doi.org/10.1007/s11701-022-01484-9

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