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单孔与多孔机器人辅助单纯前列腺切除术:来自单孔高级研究联盟(SPARC)的多机构研究。

Single Port Versus Multiport Robot-assisted Simple Prostatectomy: A Multi-institutional Study From the Single-port Advanced Research Consortium (SPARC).

机构信息

Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH.

The Mount Sinai Hospital, New York, NY.

出版信息

Urology. 2023 Jun;176:94-101. doi: 10.1016/j.urology.2023.03.022. Epub 2023 Mar 29.

Abstract

OBJECTIVE

To compare robot-assisted simple prostatectomy intraoperative and postoperative.ßoutcomes between single-port (SP) and multiport (MP) robotic systems in a multi-institutional setting.

METHODS

We analyzed all-consecutive robot-assisted simple prostatectomy cases done in 5 centers from January 2017 to October 2022. Data were analyzed with descriptive statistics and compared with appropriate tests depending on the type of variable and distribution. Statistical significance was considered when P.ß<.05.

RESULTS

A total of 405 cases were analyzed:.ß249 and 156 were MP and SP, respectively. Operative times were similar between groups (P.ß=.ß.62). Estimated blood loss during surgery was significantly lower with the SP robot (P.ß<.001). Postoperatively, the SP approach required a significantly shorter hospital stay, less use of opioids, and a shorter duration of Foley catheter (P.ß<.001). There was no significant difference between the post-operative Clavien-Dindo ...3 complication rate (P.ß=.ß.30). The 30-day readmission rate of MP (10.8%) was significantly higher than for SP (0%) (P.ß<.001). De novo urge incontinence was more common in the MP group (P.ß=.ß.02).

CONCLUSION

The SP robotic approach to simple prostatectomy is advantageous when it comes to postoperative comfort for patients. Specifically, it requires a shorter hospital stay, less use of opioids, and a shorter Foley catheter duration.

摘要

目的

在多机构环境中比较单端口 (SP) 和多端口 (MP) 机器人系统在机器人辅助单纯前列腺切除术的术中及术后结果。

方法

我们分析了 2017 年 1 月至 2022 年 10 月 5 个中心连续进行的所有机器人辅助单纯前列腺切除术病例。采用描述性统计方法分析数据,并根据变量和分布的类型选择适当的检验方法进行比较。当 P 值<.05 时认为具有统计学意义。

结果

共分析了 405 例病例:MP 组和 SP 组分别为 249 例和 156 例。两组的手术时间相似(P 值=.62)。SP 机器人术中估计出血量明显较低(P 值<.001)。术后,SP 组的住院时间、阿片类药物使用量和 Foley 导管留置时间明显较短(P 值<.001)。两组术后 Clavien-Dindo.3 级并发症发生率无显著差异(P 值=.30)。MP 组(10.8%)的 30 天再入院率明显高于 SP 组(0%)(P 值<.001)。MP 组新发急迫性尿失禁更为常见(P 值=.02)。

结论

对于患者的术后舒适度,SP 机器人辅助单纯前列腺切除术具有优势。具体来说,它需要较短的住院时间、较少的阿片类药物使用和较短的 Foley 导管留置时间。

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