Robotic enucleation for pediatric insulinoma with MEN1 syndrome: a case report and literature review.

Robotic enucleation for pediatric insulinoma with MEN1 syndrome: a case report and literature review.
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患有 MEN1 综合征的儿童胰岛素瘤的机器人剜除术:病例报告和文献综述。

DOI:
10.1186/s12893-018-0376-5
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发表时间:
2018-06-19
期刊:
影响因子:
1.9
通讯作者:
Zhao Y
Zhao Y
中科院分区:
医学4区
文献类型:
--
作者:
Liang M;Jiang J;Dai H;Hong X;Han X;Cong L;Tong A;Li F;Luo Y;Liu W;Zhou L;Di W;Wu W;Zhao Y

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一例罕见的儿童胰岛素瘤和MEN1综合征患者接受了机器人眼球摘除手术。我们报告一个9岁女孩的病例,她表现为反复意识丧失,伴有苍白的脸色,心悸和抽搐,持续了2年,并在过去的2个月里加重。她之前在另一家医院被误诊为癫痫。我们在她住院期间对她进行了进一步检查。结合病史、影像学检查和实验室检查结果,确诊为胰岛素瘤。对外周血样本进行Sanger定向测序,发现MEN1基因突变,表明儿童胰岛素瘤伴MEN1综合征。患者在Da芬奇机器人辅助系统下接受微创胰岛素瘤摘除术,术中超声(IOUS)连接。手术在65分钟内顺利完成,女孩术后恢复良好,不再出现低血糖症状。这是第一次报告的情况下,儿童胰岛素瘤治疗使用机器人剜出。这一经验证明了将机器人手术与眼球摘除术相结合作为儿童胰岛素瘤的一种优秀策略的可行性和安全性。
A patient with a rare pediatric insulinoma and MEN1 syndrome was treated by robotic enucleation surgery. We present a case of a 9-year-old girl presenting with repeated loss of consciousness, concomitant with a pale face, palpitations, and convulsions, which had persisted for 2 years and had been aggravated during the previous 2 months. She was previously misdiagnosed with epilepsy in another hospital. We further examined her while she was hospitalized. By combining her medical history and imaging examination and lab test results, a diagnosis of insulinoma was confirmed. Sanger-directed sequencing on a peripheral blood sample revealed an MEN1 gene mutation, indicating pediatric insulinoma with MEN1 syndrome. The patient underwent minimally invasive insulinoma enucleation surgery under the Da Vinci robot-assisted system with intraoperative ultrasound (IOUS) connected. The surgery was successfully completed within 65 min, and the girl recovered well postoperatively and no longer experienced symptoms of hypoglycemia. This is the first report of a case of pediatric insulinoma treated using robotic enucleation. This experience demonstrates the feasibility and safety of combining robotic surgery with the enucleation procedure as an excellent strategy for pediatric insulinoma.
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