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单端口与多端口机器人辅助部分肾切除术围手术期结局的倾向评分匹配比较:来自单端口高级研究联盟(SPARC)的报告。

A Propensity-Matched Comparison of the Perioperative Outcomes Between Single-Port and Multi-Port Robotic Assisted Partial Nephrectomy: A Report from the Single Port Advanced Research Consortium (SPARC).

机构信息

Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

J Endourol. 2022 Dec;36(12):1526-1531. doi: 10.1089/end.2022.0115. Epub 2022 Sep 22.

Abstract

Single-port (SP) robotic surgery is a new technology and early in its adoption curve. The goal of this study is to compare the perioperative outcomes of SP to multi-port (MP) robotic technology for partial nephrectomy. This is a prospective cohort study of patients who have undergone robot-assisted partial nephrectomy using SP and MP technology. Baseline demographic, clinical, and tumor-specific characteristics and perioperative outcomes were compared using , -test, and Mann-Whitney test in the overall cohort and in a 1:1 propensity score-matched cohort, adjusting for baseline characteristics. After propensity matching, 146 SP patients were matched with 146 MP patients. SP and MP groups had similar mean age (58 ± 12 years 59 ± 12 years;  = 0.606) and proportion of men (54.11% 52.05%;  = 0.725). The SP had a longer mean ischemia (18.29 ± 10.49 minutes 13.79 ± 6.29 minutes;  < 0.001). Estimated blood loss (EBL) and length of hospital stay (LOS), operative time, positive margin rate, and any complication rate were similar between the two groups. SP partial nephrectomy had a longer ischemia time, and a comparable LOS, EBL, operative time, positive margin rates, and complication rates to MP. These early data are encouraging. However, the role of SP requires further study and should evaluate safety and long-term data when compared with the standard MP technique.

摘要

单端口 (SP) 机器人手术是一种新技术,处于采用曲线的早期阶段。本研究的目的是比较 SP 和多端口 (MP) 机器人技术用于部分肾切除术的围手术期结果。这是一项前瞻性队列研究,纳入了接受 SP 和 MP 机器人技术辅助部分肾切除术的患者。使用 、检验和 Mann-Whitney 检验比较了总体队列和 1:1 倾向评分匹配队列中的基线人口统计学、临床和肿瘤特异性特征以及围手术期结果,同时调整了基线特征。在倾向评分匹配后,146 例 SP 患者与 146 例 MP 患者相匹配。SP 和 MP 组的平均年龄(58±12 岁 59±12 岁;  = 0.606)和男性比例(54.11% 52.05%;  = 0.725)相似。SP 的平均缺血时间较长(18.29±10.49 分钟 13.79±6.29 分钟;  < 0.001)。估计失血量(EBL)和住院时间(LOS)、手术时间、阳性切缘率和任何并发症率在两组之间相似。SP 部分肾切除术的缺血时间较长,但 LOS、EBL、手术时间、阳性切缘率和并发症率与 MP 相似。这些早期数据令人鼓舞。然而,SP 的作用需要进一步研究,与标准的 MP 技术相比,应该评估其安全性和长期数据。

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