Ko Seung Yeon, Chang Young Woo, Ku Dohoe, Yu Da Young, Lee Hye Yoon, Ji Woong Bae, Son Gil Soo
Department of Surgery, Korea University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2023 Aug;105(2):69-75. doi: 10.4174/astr.2023.105.2.69. Epub 2023 Aug 1.
This study aimed to compare the intraoperative and postoperative outcomes between robotic and laparoscopic transperitoneal adrenalectomies.
In this retrospective study, 93 patients underwent adrenalectomy using 2 surgical modalities: 45 patients underwent adrenalectomy using the da Vinci Xi system (robotic group), and 48 patients using laparoscopic devices (laparoscopic group). We compared the operation time, intraoperative bleeding, and hospital stay according to the surgical modality and tumor characteristics.
There were no significant differences in the operative time (P = 0.827), hospital stay (P = 0.177), and intraoperative bleeding (P = 0.174) between the groups. However, the robotic group showed a lower coefficient of variation in total operative time than that of the laparoscopic group (100.6 ± 23.3 minutes 101.9±32.7 minutes, 0.230 0.321). When divided into 2 subgroups based on the tumor size (<3 cm and ≥3 cm), the robotic group with a tumor sized >3 cm had a shorter operative time than that of the laparoscopic group (P = 0.032). The robotic group also had fewer cases of intraoperative bleeding (P = 0.034).
Compared to the laparoscopic transperitoneal adrenalectomy, the robotic one achieved a lower deviation in total operative time and showed less bleeding and a shorter operative time, especially for tumors sized >3 cm.
本研究旨在比较机器人辅助经腹肾上腺切除术与腹腔镜经腹肾上腺切除术的术中及术后结果。
在这项回顾性研究中,93例患者接受了两种手术方式的肾上腺切除术:45例患者使用达芬奇Xi系统进行肾上腺切除术(机器人手术组),48例患者使用腹腔镜设备(腹腔镜手术组)。我们根据手术方式和肿瘤特征比较了手术时间、术中出血量和住院时间。
两组之间的手术时间(P = 0.827)、住院时间(P = 0.177)和术中出血量(P = 0.174)无显著差异。然而,机器人手术组总手术时间的变异系数低于腹腔镜手术组(100.6±23.3分钟对101.9±32.7分钟,0.230对0.321)。根据肿瘤大小(<3 cm和≥3 cm)分为两个亚组时,肿瘤大小>3 cm的机器人手术组手术时间比腹腔镜手术组短(P = 0.032)。机器人手术组术中出血病例也较少(P = 0.034)。
与腹腔镜经腹肾上腺切除术相比,机器人辅助经腹肾上腺切除术在总手术时间上偏差更小,出血更少,手术时间更短,尤其是对于肿瘤大小>3 cm的情况。