目的：总结达芬奇机器人辅助腹腔镜下改良Swenson术治疗儿童先天性巨结肠症的经验及短中期疗效。 方法：以 2020 年 6 月—2022 年 8 月贵州医科大学附属医院小儿外科行机器人辅助腹腔镜下改良 Swenson 术的 28 例 先天性巨结肠症患儿为研究对象。采用达芬奇机器人 Xi 手术系统，经盆腔浆膜下游离直肠至齿状线附近，经肛门 套叠后切除病变肠管，与正常肛管吻合。收集患儿的基本资料、手术参数和术后结果并进行回顾性分析。结果：所 有患儿均顺利完成手术，无中转开腹，平均手术时间（165±34）min，平均手术出血量（9.8±5.2）ml，平均住院时 间（10.54±4.25）d，平均随访时间（18.5±3.0）个月；近期术后并发症 4 例，其中 3 例肛周皮炎，1 例小肠结肠炎； 远期并发症 3 例，其中 2 例小肠结肠炎，1 例肛周皮炎。结论：达芬奇机器人辅助腹腔镜下改良 Swenson 术是一种 安全可行的手术方式，能够有效降低术后并发症的发生率。

Objective: To investigate the mid-term outcomes and experience of Da Vinci Robot-assisted laparoscopic modified Swenson procedure for Hirschsprung’s disease (HSCR). Methods: From June 2020 to August 2022, 28 children with HSCR who underwent Da Vinci robot-assisted laparoscopic modified Swenson operation in the Department of Pediatric Surgery, Affiliated Hospital of Guizhou Medical University were selected as the research objects. The Da Vinci Xi surgical system was used to separate rectum from its serosa to dentate line by keeping the anatomical plane away from the Denonvilliers’ fascia and presacral fascia. After anal intussusception, the diseased section of bowel was removed. The normal intestinal canal was anastomosed to the anus using interrupted absorbable sutures. The general data, surgical indicators and postoperative outcomes of patients were collected and retrospectively analyzed. Results: All surgeries were successfully completed without conversion to laparotomy. The average operative time was (165±34) minutes, and the average blood loss was (9.8±5.2) ml, with an average hospital stay of (10.54±4.25) days and average follow-up time of (18.5±3.0) months. There were 4 cases of early postoperative complications, including 3 cases of perianal dermatitis and 1 case of colitis in small intestine. There were 3 cases of late complications, including 2 cases of colitis in small intestine and 1 case of perianal dermatitis. Conclusion: Da Vinci robot-assisted laparoscopic modified Swenson procedure is safe and feasible in the treatment of children with HSCR, which can effectively reduce the incidence of postoperative complications.

收稿日期：2023-03-14  录用日期：2023-10-31 

Received Date: 2023-03-14  Accepted Date: 2023-10-31 

基金项目：贵州省卫生健康委科学技术基金项目（gzwk2022-134） 

Foundation Item: Science and Technology Foundation of Health Commission of Guizhou Province (gzwk2022-134) 

通讯作者：杜君，Email：1091766236qq.com 

Corresponding Author: DU Jun, Email: 1091766236qq.com 

引用格式：杨嘉飞，杜君，谷化剑，等 . 达芬奇机器人辅助腹腔镜下改良 Swenson 术治疗先天性巨结肠症的疗效研究 [J]. 机器人 外科学杂志（中英文），2024，5（4）：666-670. 

Citation: YANG J F, DU J, GU H J, et al. Effect of Da Vinci robot-assisted laparoscopic modified Swenson procedure in children with Hirschsprung’s disease[J]. Chinese Journal of Robotic Surgery, 2024, 5(4): 666-670.

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