Department of Urology, School of Medicine, Xin Hua Hospital, Shanghai Jiao Tong University, Shanghai, China.
Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
J Robot Surg. 2024 Oct 7;18(1):362. doi: 10.1007/s11701-024-02111-5.
A nephroureterectomy conventionally consists of two independent section, which will considerably prolong the operation time. We developed a novel surgical technique for robotic-assisted laparoscopic nephroureterectomy without re-docking in a single position and aimed to access the safety, feasibility, and efficiency of our novel surgical technique. From August 2021 to October 2023, 53 patients who received robotic-assisted laparoscopic nephroureterectomy were retrospectively enrolled in this study. 25 patients underwent traditional nephroureterectomy and 28 patients underwent single-position nephroureterectomy. The basic characteristics of the enroll patients, perioperative parameters, and oncological outcomes were gathered and compared between novel technique robotic surgery group and traditional surgery group. The basic characteristics between two groups had no significantly difference except for the proportion of anticoagulation therapy. The operation time in novel technique robotic surgery group was shorter than that in traditional robotic surgery group, although there was no significant difference (p = 0.403). Lymph-node dissection in novel technique robotic surgery group was obvious more common than that in traditional robotic surgery group (p = 0.037), while the incision length in novel technique robotic surgery group was obviously shorter than that in traditional robotic surgery group (p < 0.001). The oncological outcomes showed no difference between two groups. Compared with traditional robotic-assisted laparoscopic nephroureterectomy, the innovative surgical technique of robotic-assisted laparoscopic nephroureterectomy in a single position showed the advantages of less surgical time, streamlined lymph-node dissection, less trauma, and expedited postoperative recovery, which is worth promoting in clinical practice.
传统的肾输尿管切除术通常由两个独立的部分组成，这将大大延长手术时间。我们开发了一种新的机器人辅助腹腔镜肾输尿管切除术技术，无需重新对接即可在单个位置进行，旨在评估我们新技术的安全性、可行性和效率。从 2021 年 8 月到 2023 年 10 月，我们回顾性地招募了 53 名接受机器人辅助腹腔镜肾输尿管切除术的患者。25 名患者接受传统肾输尿管切除术，28 名患者接受单位置肾输尿管切除术。收集并比较了两组患者的基本特征、围手术期参数和肿瘤学结果。除抗凝治疗的比例外，两组患者的基本特征无显著差异。虽然新型机器人手术组的手术时间比传统机器人手术组长，但无统计学差异（p=0.403）。新型机器人手术组的淋巴结清扫明显比传统机器人手术组更常见（p=0.037），而新型机器人手术组的切口长度明显短于传统机器人手术组（p<0.001）。两组的肿瘤学结果无差异。与传统机器人辅助腹腔镜肾输尿管切除术相比，单位置机器人辅助腹腔镜肾输尿管切除术的创新手术技术具有手术时间更短、简化淋巴结清扫、创伤更小、术后恢复更快的优势，值得在临床实践中推广。
