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森恩希(Senhance)机器人与达芬奇(da Vinci)机器人根治性前列腺切除术的比较:短期疗效、学习曲线和成本分析。

Comparison of senhance and da vinci robotic radical prostatectomy: short-term outcomes, learning curve, and cost analysis.

机构信息

Department of Urology, National Taiwan University Hospital, Yunlin branch, Yunlin, Taiwan.

Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.

出版信息

Prostate Cancer Prostatic Dis. 2024 Mar;27(1):116-121. doi: 10.1038/s41391-023-00717-8. Epub 2023 Sep 2.

Abstract

BACKGROUND

The Senhance® Robotic System is a new laparoscopy-based platform that has been increasingly used in radical prostatectomy (RP) procedures. The purpose of this study is to compare the outcome of Senhance RP (SRP) with da Vinci RP (DRP) cases.

METHODS

From August 2019 to April 2022, we prospectively recruited 63 cases of SRP. We compared the perioperative data, postoperative complication rates, short-term surgical outcomes (3-month postoperative undetectable prostate-specific antigen (PSA) and incontinence rates), learning curves, and cost analysis with data from 63 matched da Vinci Xi RP cases.

RESULTS

There was no difference in BL (180 versus 180 ml, p = 0.86) and postoperative surgical complication rate (Clavient -Dindo grade I-IV, 25.3 versus 22.2%, p = 0.21) between the SRP cases and the DRP. Regarding the oncologic and continence function, there was no difference between positive margin rate (36.5% versus 41.3%, p = 0.58), rate of undetectable PSA level at postoperative 3 months (68.3 versus 66.7%, p = 0.85), and incontinence rate (14.3 versus 15.9%, p = 1.0) at postoperative 3 months between the two cohorts. The learning curve showed a quick downward slope for laparoscopic experienced surgeons. The median pocket cost for SRP patients in our hospital was $4170, which was lower than $7675 for the DRP patients.

CONCLUSIONS

Safety and short-term outcomes are comparable between SRP and DRP. For experienced LRP surgeons, using the Senhance system to perform RP is straightforward. With a more affordable price as its biggest advantage, the Senhance system may serve as a safe and effective alternative for robotic RP.

摘要

背景

Senhance® 机器人系统是一种新的腹腔镜平台,已越来越多地用于根治性前列腺切除术(RP)。本研究旨在比较 Senhance RP(SRP)与 da Vinci RP(DRP)的结果。

方法

从 2019 年 8 月至 2022 年 4 月,我们前瞻性地招募了 63 例 SRP 患者。我们将围手术期数据、术后并发症发生率、短期手术结果(术后 3 个月前列腺特异性抗原(PSA)不可检测率和尿失禁率)、学习曲线和成本分析与 63 例匹配的 da Vinci Xi RP 病例的数据进行比较。

结果

SRP 组和 DRP 组的膀胱容量(BL)(180 与 180ml,p=0.86)和术后手术并发症发生率(Clavient-Dindo 分级 I-IV,25.3 与 22.2%,p=0.21)无差异。在肿瘤学和控尿功能方面,两组的阳性切缘率(36.5%与 41.3%,p=0.58)、术后 3 个月 PSA 水平不可检测率(68.3%与 66.7%,p=0.85)和尿失禁率(14.3%与 15.9%,p=1.0)无差异。学习曲线显示腹腔镜经验丰富的外科医生的斜率迅速下降。我院 SRP 患者的口袋成本中位数为 4170 美元,低于 DRP 患者的 7675 美元。

结论

SRP 和 DRP 的安全性和短期结果相当。对于经验丰富的 LRP 外科医生来说,使用 Senhance 系统进行 RP 操作简单。Senhance 系统作为一种安全有效的 RP 替代方法,其最大优势是价格更实惠。

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