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机器人辅助与传统腹腔镜部分肾切除术的益处:单中心外科医生比较研究

Benefits of Robotic Assisted vs. Traditional Laparoscopic Partial Nephrectomy: A Single Surgeon Comparative Study.

作者信息

Bray Gerard, Bahadori Arya, Mao Derek, Ranasinghe Sachinka, Tracey Christopher

机构信息

Urology Department, Gold Coast University Hospital, Gold Coast, QLD 4215, Australia.

Department of Medicine, Bond University, Gold Coast, QLD 4226, Australia.

出版信息

J Clin Med. 2022 Nov 26;11(23):6974. doi: 10.3390/jcm11236974.

Abstract

PURPOSE

The current study aims to compare peri-operative and post-operative outcomes between robotic assisted vs. laparoscopic partial nephrectomy. Multiple reviews of the current literature have detailed the lack of single surgeon studies in this domain. To limit inter-operator bias, we utilise a single surgeon experienced in both approaches to reduce this bias seen in other multi-centre studies.

METHODS AND MATERIALS

We retrospectively compared patient demographics, tumour characteristics, peri-operative and post-operative outcomes of all partial nephrectomies undertaken by a single surgeon between 2014 and 2021 with experience in both laparoscopic and robotic surgery. The Da Vinci surgical system was utilized. Statistical analysis was carried out using GraphPad prism software version 7.03, San Diego, CA, USA.

RESULTS

Warm ischemia time was reduced by 2.6 min, length of stay reduced by 1.3 days and acute renal function deterioration was reduced by 55% with all these results being significant with robotic assisted partial nephrectomy compared to laparoscopic partial nephrectomy.

CONCLUSION

This study highlights the benefits of robotic assisted in comparison to laparoscopic partial nephrectomy. Further large-scale prospective studies and cost-benefit analysis of robotic assisted partial nephrectomy would be valuable in confirming these findings and justifying the usage against their financial cost.

摘要

目的

本研究旨在比较机器人辅助与腹腔镜下部分肾切除术的围手术期和术后结果。目前对现有文献的多项综述详细说明了该领域缺乏单外科医生的研究。为了限制手术医生之间的偏差,我们采用了一位在两种手术方法上都有经验的单外科医生,以减少在其他多中心研究中出现的这种偏差。

方法和材料

我们回顾性比较了2014年至2021年期间一位在腹腔镜和机器人手术方面均有经验的单外科医生进行的所有部分肾切除术患者的人口统计学资料、肿瘤特征、围手术期和术后结果。使用了达芬奇手术系统。使用美国加利福尼亚州圣地亚哥的GraphPad prism软件7.03进行统计分析。

结果

与腹腔镜下部分肾切除术相比,机器人辅助部分肾切除术的热缺血时间减少了2.6分钟,住院时间减少了1.3天,急性肾功能恶化减少了55%,所有这些结果均具有统计学意义。

结论

本研究突出了机器人辅助相对于腹腔镜下部分肾切除术的优势。进一步的大规模前瞻性研究以及机器人辅助部分肾切除术的成本效益分析,对于证实这些发现并证明其相对于财务成本的使用合理性将具有重要价值。

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