Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Urology. 2011 Sep;78(3):581-5. doi: 10.1016/j.urology.2010.10.046. Epub 2011 Jul 23.
To compare the outcomes between 2-port robot-assisted partial nephrectomy (2-portRALPN) and standard robot-assisted laparoscopic partial nephrectomy (sRALPN).
From May 2009 to February 2010, 35 2-portRALPN were done by a single surgeon in a university-based tertiary referral center. A cohort of 35 patients who underwent sRALPN from September 2006 to July 2009 was selected for retrospective comparison and matched for tumor complexity. All patients underwent partial nephrectomy (PN) using the daVinci surgical robotic platform (Intuitive Surgical, Sunnyvale, CA). In the 2-portRALPN, a homemade umbilical port and an infraumbilical assistant port were used, whereas standard laparoscopic port placement was used for sRALPN. The clinical, operative, pathologic, and follow-up information were collected.
The operative time (187.5 vs 171.7 minutes, P=.110), warm ischemia time (29.5 vs 28.8 minutes, P=.209), blood loss (257 vs 242.5 mL, P=.967), complication rate (17.1 vs 11.4%, P=.495), and transfusion rate (8.6 vs 2.9%, P=.303) were comparable in both groups. The pain scores on the first postoperative day (4.5 vs 3.9, P=.236) and on the day of discharge (2.3 vs 1.9, P=.433), in-hospital morphine requirement (130.5 vs 122.2 mg, P=.115), and length of hospital stay (4.2 vs 4.2 days, P=.875) were likewise similar in both groups.
This matched-pair study design comparing 2-portRALPN with sRALPN shows that the outcomes of both techniques are comparable. The 2-portRALPN technique is a viable option until a more advanced robotic platform specifically designed for laparoendoscopic single-site surgery is developed and a pure robot-assisted laparoendoscopic single site surgery PN can be safely performed.
比较两孔机器人辅助部分肾切除术（2 端口 RALPN）与标准机器人辅助腹腔镜部分肾切除术（sRALPN）的结果。
从 2009 年 5 月至 2010 年 2 月，一位外科医生在一家大学的三级转诊中心完成了 35 例 2 端口 RALPN。选择了一组 2006 年 9 月至 2009 年 7 月接受 sRALPN 的 35 例患者进行回顾性比较，并按肿瘤复杂性进行匹配。所有患者均采用达芬奇手术机器人平台（直觉外科公司，加利福尼亚州森尼韦尔）进行部分肾切除术（PN）。在 2 端口 RALPN 中，使用自制的脐部端口和下腹部辅助端口，而标准腹腔镜端口放置用于 sRALPN。收集临床、手术、病理和随访信息。
手术时间（187.5 分钟 vs 171.7 分钟，P=.110）、热缺血时间（29.5 分钟 vs 28.8 分钟，P=.209）、出血量（257 毫升 vs 242.5 毫升，P=.967）、并发症发生率（17.1% vs 11.4%，P=.495）和输血率（8.6% vs 2.9%，P=.303）在两组间无差异。两组患者术后第 1 天（4.5 分 vs 3.9 分，P=.236）和出院当天（2.3 分 vs 1.9 分，P=.433）疼痛评分、住院期间吗啡需求（130.5 毫克 vs 122.2 毫克，P=.115）和住院时间（4.2 天 vs 4.2 天，P=.875）也相似。
本研究比较了 2 端口 RALPN 与 sRALPN，结果表明两种技术的结果相当。2 端口 RALPN 技术是一种可行的选择，直到开发出专门用于腹腔镜单孔手术的更先进的机器人平台，并且可以安全地进行纯机器人辅助腹腔镜单孔手术 PN。
