儿童肠系膜囊肿切除术： 达芬奇机器人与腹腔镜的短期效果对比分析

doi:10.3969/j.issn.1674-8115.2026.08.012

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (8): 1117-1123.doi: 10.3969/j.issn.1674-8115.2026.08.012

• 论著 · 临床研究 • 上一篇

儿童肠系膜囊肿切除术：达芬奇机器人与腹腔镜的短期效果对比分析

陈益, 蔡多特, 宣笑笑, 陈赛, 陈青江, 高志刚()

浙江大学医学院附属儿童医院普外科，儿童少年健康与疾病国家临床医学研究中心，杭州 310052

收稿日期:2026-01-20 接受日期:2026-04-13 出版日期:2026-08-28 发布日期:2026-08-28
通讯作者: 高志刚，主任医师，博士；电子信箱：ebwk@zju.edu.cn。
作者简介:第一联系人：陈益负责研究设计，陈益、蔡多特和宣笑笑参与论文撰写和修改，陈益、陈赛和陈青江参与数据分析，陈青江和高志刚负责论文撰写指导。所有作者均阅读并同意最终稿件的提交。
基金资助:
浙江大学-金赛药业儿童健康联合研究项目(ZJU-GENSCI2024ZD002)

Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy

Chen Yi, Cai Duote, Xuan Xiaoxiao, Chen Sai, Chen Qingjiang, Gao Zhigang()

Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine; National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou 310052, China

Received:2026-01-20 Accepted:2026-04-13 Online:2026-08-28 Published:2026-08-28
Contact: Gao Zhigang, E-mail: ebwk@zju.edu.cn.
About author:First author contact:The study was designed by Chen Yi. The manuscript was drafted and revised by Chen Yi, Cai Duote, and Xuan Xiaoxiao. Chen Yi, Chen Sai, and Chen Qingjiang were responsible for data analysis. Chen Qingjiang and Gao Zhigang were responsible for guidance on the manuscript writing. All authors have read the final version of the paper and consented to its submission.
Supported by:
Joint Research Program on Children's Health between Zhejiang University and Gensci Pharmaceutical(ZJU-GENSCI2024ZD002)

摘要/Abstract

摘要：

目的·比较分析达芬奇机器人与腹腔镜在儿童肠系膜囊肿切除术应用中的短期效果。方法·回顾性分析2020年1月至2025年8月于浙江大学医学院附属儿童医院普外科行达芬奇机器人辅助和腹腔镜辅助肠系膜囊肿切除术的71例患儿临床资料，根据手术方式不同，将患儿分为达芬奇手术组（n=33）和腹腔镜手术组（n=38）。对比分析2组的一般资料、手术时间、术中出血量、手术完成方式、囊肿位置、囊肿最大径、术后禁食时间、术后住院时间以及术后并发症等指标，分析2种方法的优劣。结果·一般资料比较结果显示，2组患儿性别、月龄、体质量、临床症状、囊肿位置、囊肿最大径等方面的差异均无统计学意义（均P>0.05）。在手术完成方式方面，达芬奇手术组33例（100%）患儿全部在腹腔内完成囊肿剥离或肠切除及肠吻合；腹腔镜手术组仅有3例（7.9%）全部手术操作在腹腔内完成，其他病例均在腹腔外完成。2组手术完成方式构成比差异有统计学意义（P<0.001）。2组在手术时间、术后禁食时间上差异均无统计学意义（均P>0.05），但达芬奇手术组的术中出血量显著少于腹腔镜手术组［5（2，5）mL vs 6（5，10）mL，P<0.001］，术后住院时间也较短［9（7，11）d vs 10.5（8，13）d，P=0.033］。达芬奇手术组患儿未见明显并发症；腹腔镜手术组则有1例患儿术中出现输尿管损伤，1例术后出现乳糜瘘。所有患儿出院后随访6个月均恢复良好，未见囊肿复发。结论·与腹腔镜相比，达芬奇机器人手术治疗儿童肠系膜囊肿可显著提升完全腹腔内操作比例，且具有术中出血更少、术后恢复更快的特点，短期疗效确切、安全性良好。

关键词: 肠系膜囊肿, 达芬奇机器人, 腹腔镜, 儿童

Abstract:

Objective ·To compare and analyze the short-term effect of the Da Vinci robotic system and laparoscopy for the resection of mesenteric cyst in children. Methods ·A retrospective analysis was conducted on the clinical data of 71 children who underwent Da Vinci robotic-assisted or laparoscopic-assisted mesenteric cyst resection in the Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine between January 2020 and August 2025. Patients were divided into the Da Vinci group (n=33) and the laparoscopic group (n=38) based on surgical approach. Comparative analysis of baseline characteristics, operative time, intraoperative blood loss, mode of surgical completion, cyst location, maximum cyst diameter, postoperative fasting time, postoperative hospital stay, and postoperative complications was performed to evaluate the advantages and disadvantages of the two approaches. Results ·Baseline characteristics showed no statistically significant differences between the two groups in gender, age, weight, clinical symptoms, cyst location, or maximum cyst diameter (all P>0.05). Regarding the mode of surgical completion, all 33 patients (100%) in the Da Vinci group underwent complete intracavitary cyst dissection or bowel resection and anastomosis; only 3 patients (7.9%) in the laparoscopic group completed all procedures via an intracavitary approach, while the remaining patients required extraperitoneal completion of the procedure. The distribution of surgical completion modes differed significantly between the two groups (P<0.001). There were no statistically significant differences in operative time or postoperative fasting time between the two groups (both P>0.05). Intraoperative blood loss was significantly lower in the Da Vinci group than in the laparoscopic group [5 (2, 5) mL vs 6 (5, 10) mL, P<0.001], and postoperative hospital stay was also significantly shorter in the Da Vinci group [9 (7,11) d vs 10.5 (8,13) d, P=0.033]. No complications were observed in the Da Vinci group. In the laparoscopic group, one patient experienced intraoperative ureteral injury, and one developed postoperative chylous fistula. All patients were followed up for 6 months after discharge and achieved favorable recovery without cyst recurrence. Conclusion ·Compared with laparoscopic surgery, the Da Vinci robotic approach for pediatric mesenteric cyst resection markedly increases the rate of complete intracavitary procedures, with the merits of less intraoperative hemorrhage and faster postoperative recovery. It demonstrates reliable short-term efficacy and favorable safety.

Key words: mesenteric cyst, Da Vinci robotic system, laparoscopy, child

中图分类号:

R726.1

陈益, 蔡多特, 宣笑笑, 陈赛, 陈青江, 高志刚. 儿童肠系膜囊肿切除术：达芬奇机器人与腹腔镜的短期效果对比分析[J]. 上海交通大学学报（医学版）, 2026, 46(8): 1117-1123.

Chen Yi, Cai Duote, Xuan Xiaoxiao, Chen Sai, Chen Qingjiang, Gao Zhigang. Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(8): 1117-1123.

图/表 4

图1 达芬奇机器人辅助肠系膜囊肿切除套管针布局图Note： A. The umbilicus and the mesenteric cyst in the lower abdomen were taken as two reference points to draw line a, and then line b was drawn perpendicular to line a through the umbilicus (point 2). Two points (1 and 3) were marked on line b about 5‒8 cm from the umbilicus. Points 1, 2, and 3 were the positions of the Da Vinci 8-mm trocars, and point 4 was the position of the 5-mm laparoscopic port for the assistant surgeon, when necessary. B. Placement of Da Vinci trocars while the cyst was located in the lower abdomen. C. Placement of Da Vinci trocars while the cyst was located in the upper abdomen.

Fig 1 Trocar placement for Da Vinci robotic-assisted mesenteric cyst resection

图2 达芬奇机器人辅助肠系膜囊肿切除术Note： A‒D. A 9-year-old girl. A. The cyst involved the ileal mesentery. B. The cyst was completely removed without bowel resection, and the mesenteric blood vessels were preserved. C. The mesenteric defect was repaired. D. The cyst was removed using a retrieval bag. E‒H. An 8-year-old boy. E. The cyst involved the ileal mesentery and adhered to the surrounding intestine. F. The cyst was removed with segmental bowel resection. G. Intracorporeal intestinal anastomosis was performed by means of intestinal suspension traction. H. The mesenteric defect was closed.

Fig 2 Da Vinci robotic-assisted laparoscopic resection of mesenteric cysts

表1 达芬奇手术组和腹腔镜手术组肠系膜囊肿患儿的临床资料比较

Tab 1 Comparison of clinical characteristics of children with mesenteric cysts between the Da Vinci group and the laparoscopic group

Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Gender/n(%)			0.474
Male	21 (63.6)	21 (55.3)
Female	12 (36.4)	17 (44.7)
Age/month	63.0 (43.0, 85.0)	44.5 (22.5, 82.3)	0.185
Weight/kg	18.5 (15.2, 23.5)	14.8 (11.9, 21.0)	0.054
Symptomatic case/n(%)	26 (78.8)	28 (73.7)	0.615
Abdominal pain	23 (69.7)	23 (60.5)	0.420
Vomiting	9 (27.3)	12 (31.6)	0.585
Fever	8 (24.2)	8 (21.1)	0.748
Maximum diameter of cyst/cm	6.0 (5.0, 9.0)	8.0 (6.0, 10.3)	0.101
Mesenteric root cyst/n(%)	6 (18.2)	6 (15.8)	0.788
Cyst location/n(%)			0.928
Small intestine	24 (72.7)	28 (73.7)
Colon	9 (27.3)	10 (26.3)

表2 达芬奇手术组和腹腔镜手术组肠系膜囊肿患儿的术中及术后情况比较

Tab 2 Comparison of intraoperative and postoperative outcomes of children with mesenteric cysts between the Da Vinci group and the laparoscopic group

Index	Da Vinci group (n=33)	Laparoscopic group (n=38)	P value
Operative time/min	133.0 (85.0, 180.0)	111.5 (76.8, 150.5)	0.230
Blood loss/mL	5 (2, 5)	6 (5, 10)	<0.001
Surgical procedure^①/n(%)			<0.001
Cyst excision intracorporeally	12 (36.4)	3 (7.9)
Intestinal resection and anastomosis intracorporeally	21 (63.6)	0 (0)
Cyst excision extracorporeally	0 (0)	9 (23.7)
Intestinal resection and anastomosis extracorporeally	0 (0)	26 (68.4)
Postoperative fasting time/d	4 (3, 5)	4 (3, 5)	0.775
Postoperative hospital stay/d	9 (7, 11)	10.5 (8, 13)	0.033
Total cost/yuan	66 607 (58 985, 71 788)	19 715 (15 928, 27 726)	<0.001
Revised cost^②/yuan	22 306 (18 100, 26 751)	19 715 (15 928, 27 726)	0.152
Complication/n(%)	0 (0)	2 (5.26)	0.495
Postoperative recurrence/n(%)	0 (0)	0 (0)	>0.999

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儿童肠系膜囊肿切除术：达芬奇机器人与腹腔镜的短期效果对比分析

Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy

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儿童肠系膜囊肿切除术： 达芬奇机器人与腹腔镜的短期效果对比分析

Mesenteric cyst resection in children: a comparative analysis of the short-term effect of Da Vinci robotic system and laparoscopy

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儿童肠系膜囊肿切除术：达芬奇机器人与腹腔镜的短期效果对比分析