Rhee Jonathan J, Lebeau Sam, Smolkin Mark, Theodorescu Dan
Department of Urology, University of Virginia, Charlottesville, VA 22908, USA.
BJU Int. 2006 Nov;98(5):1059-63. doi: 10.1111/j.1464-410X.2006.06372.x. Epub 2006 Jun 26.
To compare the performance of radical cystectomy with ileal conduit diversion by standard methods with that using the assistance of the daVinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA).
From November 2003 to August 2005, we performed 30 radical cystectomies with ileal conduit urinary diversions on patients with bladder cancer. Seven patients (one woman) had a cystectomy with the daVinci system and 23 (nine women) had a standard cystectomy. Data were collected prospectively, including estimated blood loss (EBL), transfusion requirement, operative duration, hospital stay and body mass index (BMI), and compared.
The mean EBL and transfusion requirements for standard and daVinci-assisted cases was 1109 and 479 mL (P = 0.002) and 2.7 and 1.6 units (P = 0.14), respectively. Four of seven patients received a transfusion in the robotic group, and 20 of 23 in the standard group (P = 0.084). The mean operative duration was 638 and 507 min (P = 0.005) for the daVinci and standard group, respectively, with respective mean hospital stays of 11 and 13 days (P = 0.52). There was no difference in patient BMI between the groups (P = 0.22).
The daVinci-assisted cystectomy appears to offer some advantages over standard cystectomy. Larger randomized studies are needed to confirm these findings.
比较采用标准方法行根治性膀胱切除术加回肠膀胱术与使用达芬奇机器人系统（美国加利福尼亚州森尼韦尔市直观外科公司）辅助行该手术的效果。
2003年11月至2005年8月，我们对膀胱癌患者进行了30例根治性膀胱切除术加回肠膀胱尿流改道术。7例患者（1名女性）采用达芬奇系统行膀胱切除术，23例患者（9名女性）行标准膀胱切除术。前瞻性收集数据，包括估计失血量（EBL）、输血需求、手术时间、住院时间和体重指数（BMI），并进行比较。
标准手术组和达芬奇辅助手术组的平均EBL分别为1109 ml和479 ml（P = 0.002），输血需求分别为2.7单位和1.6单位（P = 0.14）。机器人手术组7例患者中有4例接受了输血，标准手术组23例患者中有20例接受了输血（P = 0.084）。达芬奇手术组和标准手术组的平均手术时间分别为638分钟和507分钟（P = 0.005），平均住院时间分别为11天和13天（P = 0.52）。两组患者的BMI无差异（P = 0.22）。
达芬奇辅助膀胱切除术似乎比标准膀胱切除术具有一些优势。需要更大规模的随机研究来证实这些发现。
