达芬奇机器人 Xi 版本与 SP 版本行单孔机器人胆囊切除术的围手术期结局评估的回顾性多中心研究。
A retrospective multicentre study on the evaluation of perioperative outcomes of single-port robotic cholecystectomy comparing the Xi and SP versions of the da Vinci robotic surgical system.
机构信息
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Surgery, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
出版信息
Int J Med Robot. 2022 Feb;18(1):e2345. doi: 10.1002/rcs.2345. Epub 2021 Nov 4.
BACKGROUND
Single-incision robotic cholecystectomy (SIRC) is widely performed with both the da Vinci Xi system (Xi) and the da Vinci SP system (SP). But there are limited numbers of studies comparing these platforms.
METHODS
Patients who underwent SIRC between 2019 and 2020 were enrolled. Patient demographics, intraoperative factors, postoperative complications, postoperative pain were compared using a one-to-one propensity score matching (PSM).
RESULTS
Overall, 258 patients underwent SIRC with Xi and 72 with SP. After PSM, there were significant differences between the Xi and SP in operation time at console and numeric rating scale for postoperative pain, but no difference in total operation time and postoperative complications. The SP group showed more estimated blood loss.
CONCLUSIONS
Despite the statistical difference, clinical benefit was not significant. Both platforms can be safe and feasible to perform SIRC, but further investigation including the surgeon's workload and ergonomics is needed as a prospective study.
背景
单切口机器人胆囊切除术（SIRC）广泛应用于达芬奇 Xi 系统（Xi）和达芬奇 SP 系统（SP）。但比较这些平台的研究数量有限。
方法
纳入 2019 年至 2020 年间行 SIRC 的患者。采用 1:1 倾向评分匹配（PSM）比较患者的人口统计学资料、术中因素、术后并发症和术后疼痛。
结果
共有 258 例患者接受了 Xi 辅助的 SIRC 和 72 例 SP 辅助的 SIRC。PSM 后，控制台操作时间和术后疼痛数字评分法（NRS）评分在 Xi 和 SP 之间存在显著差异，但总手术时间和术后并发症无差异。SP 组的估计出血量更多。
结论
尽管存在统计学差异，但临床获益并不显著。两种平台都可安全、可行地进行 SIRC，但需要进一步开展前瞻性研究，包括评估术者的工作量和手术操作的人机工程学。
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