Robotic-assisted laparoscopic management of mesenteric cysts in children

Qingjiang Chen; Shuhao Zhang; Wenjuan Luo; Duote Cai; Yuebin Zhang; Zongwei Huang; Xiaoxiao Xuan; Qixing Xiong; Zhigang Gao

doi:10.3389/fped.2022.1089168

Robotic-assisted laparoscopic management of mesenteric cysts in children

Front Pediatr. 2023 Jan 10:10:1089168. doi: 10.3389/fped.2022.1089168. eCollection 2022.

Authors

Qingjiang Chen¹, Shuhao Zhang¹, Wenjuan Luo¹, Duote Cai¹, Yuebin Zhang¹, Zongwei Huang¹, Xiaoxiao Xuan¹, Qixing Xiong¹, Zhigang Gao¹

Affiliation

¹ Department of Pediatric General Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Center for Clinical Medicine of Children's Health and Disease, National Children's Regional Medical Center, Hangzhou, China.

Abstract

Background: Mesenteric cysts (MCs) are rare intra-abdominal masses in children, and laparoscopic complete cyst resection is still difficult. This study reviewed our experience in diagnosing and managing MCs at our center, focusing on the clinical characteristics of MCs and the effectiveness of robotic-assisted laparoscopic surgery.

Methods: We conducted a retrospective analysis of the records of all patients diagnosed with MCs and managed with robotic-assisted laparoscopic surgery at our center between February 2021 and August 2022. We analyzed demographic characteristics, clinical manifestations, preoperative imaging data, surgical methods, postoperative complications, and final outcomes.

Results: Totally, 12 consecutive patients with a mean age of 5.81 ± 3.02 years were admitted. The most common symptom was abdominal pain (58.33%). Eight patients were associated with cyst complications, including five cases of infection, two cases of volvulus, and one case of hemorrhage. The mean size of cysts was 8.39 ± 5.91 cm. The cysts were located in ileal mesentery in eight cases, lesser curvature of the stomach in two cases, and colon mesentery in two cases. Solely cyst excision was performed in eight cases, and bowel en bloc resection of the cyst in four cases. Robotic-assisted laparoscopic surgery was performed successfully in all patients, without conversion. The mean operation time was 106.17 ± 33.74 min. Pathological results reported lymphangioma or lymphatic malformation in all patients. Two cases of chylous leakage were treated conservatively, and no complications of peritoneal infection, anastomotic leakage, and recurrence were observed.

Conclusions: Mesenteric cysts should be removed promptly once the diagnosis is confirmed to avoid cyst complications. For uncomplicated mesenteric cysts, laparoscopic cyst excision, or cyst excision with bowel resection can be effectively performed in children, especially under the robot system.

Keywords: children; laparoscopy; mesenteric cysts; prognosis; robotic surgery.

Grants and funding

This work was supported by grants from the Natural Science Foundation of Zhejiang Province programs (no. LY20H030007).