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达芬奇和 Hugo RAS 平台辅助机器人部分肾切除术:初步前瞻性对比分析结果。

Da Vinci and Hugo RAS Platforms for robot-assisted partial nephrectomy: a preliminary prospective comparative analysis of the outcomes.

机构信息

Department of Urology, ROC Clinic, HM Sanchinarro University Hospital, HM Hospitales, Madrid, Spain.

Service of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Minerva Urol Nephrol. 2024 Jun;76(3):303-311. doi: 10.23736/S2724-6051.24.05623-4. Epub 2024 May 17.

Abstract

BACKGROUND

Robot-assisted partial nephrectomy (RAPN) has emerged as the preferred approach for T1 renal-cell-carcinoma. As new robotic platforms like Hugo RAS emerge, we seek to understand their potential in achieving similar RAPN outcomes as the established Da Vinci system.

METHODS

A prospective single-center comparative study was conducted, and 50 patients selected for RAPN were enrolled (25 Da Vinci Xi; 25 Hugo RAS). The choice of robotic system was based solely on hospital logistics criteria. Surgeries were performed by expert surgeons. Demographic data, tumor characteristics, operative details and postoperative outcomes were collected. SPSS version 22.0 was used for statistical analyses.

RESULTS

The average age of patients was 62.52±9.47 years, with no significant differences in median age, sex, and nephrometry scores between groups. Da Vinci group showed a significantly shorter docking time (12.56 vs. 20.08 min; P<0.01), while other intraoperative measures like console time and warm ischemia time were similar. The Hugo RAS group had a shorter renorraphy time (14.33 vs. 18.84 min; P=0.024). Postoperative outcomes and surgical margin positivity showed no significant differences. Each group had one patient (4%) who developed major surgical complications (Clavien IIIa). Trifecta rates were comparable between both groups (Da Vinci 88% vs. Hugo RAS 84%; P=0.93).

CONCLUSIONS

Initial findings suggest similar perioperative outcomes for RAPN when using Hugo RAS compared to the Da Vinci system. Further research with long-term follow-up is necessary to evaluate oncological and functional outcomes.

摘要

背景

机器人辅助部分肾切除术 (RAPN) 已成为 T1 肾细胞癌的首选治疗方法。随着 Hugo RAS 等新型机器人平台的出现,我们试图了解它们在实现与达芬奇系统相似的 RAPN 结果方面的潜力。

方法

进行了一项前瞻性单中心对照研究,共纳入 50 例接受 RAPN 的患者(达芬奇 Xi 组 25 例,Hugo RAS 组 25 例)。机器人系统的选择仅基于医院物流标准。手术由专家外科医生进行。收集人口统计学数据、肿瘤特征、手术细节和术后结果。使用 SPSS 版本 22.0 进行统计分析。

结果

患者的平均年龄为 62.52±9.47 岁,两组的中位年龄、性别和肾肿瘤评分无显著差异。达芬奇组的对接时间明显更短(12.56 分钟对 20.08 分钟;P<0.01),而控制台时间和热缺血时间等其他术中指标相似。Hugo RAS 组的肾缝合时间更短(14.33 分钟对 18.84 分钟;P=0.024)。术后结果和手术切缘阳性率无显著差异。两组各有 1 例(4%)患者发生主要手术并发症(Clavien IIIa 级)。两组 trifecta 率相当(达芬奇组 88%对 Hugo RAS 组 84%;P=0.93)。

结论

初步研究结果表明,使用 Hugo RAS 进行 RAPN 的围手术期结果与达芬奇系统相似。需要进行长期随访的进一步研究来评估肿瘤学和功能学结果。

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