Bang Seokhwan, Yu Jiwoong, Bae Hoyoung, Shin Dongho, Park Yong Hyun, Cho Hyuk Jin, Ha U-Syn, Lee Ji Youl, Hong Sung-Hoo
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Endourol. 2024 Dec;38(12):1353-1358. doi: 10.1089/end.2024.0493. Epub 2024 Oct 24.
To compare the surgical results of retroperitoneal (RP) robot partial nephrectomy (PNx) using either a single-port robot (SP) or a multi-port robot (MP). We retrospectively reviewed all RP robotic PNx performed at a single institution from September 2021-when the SP robot was introduced to the institution-through April 2023. In total, 125 patients underwent the surgery; 81 patients were treated with surgery using a MP robot whereas 44 patients were treated with surgery using a SP. All MP surgeries were performed with da Vinci Xi (Intuitive, Sunnyvale, California, USA), while all SP surgeries were performed with da Vinci SP (Intuitive, Sunnyvale, California, USA). We performed a propensity score-matching (PSM) analysis of these 125 patients. There was no significant difference between the two groups after PSM. In terms of operation time, that for MP was 103.68 ± 21.89 minutes whereas that for SP was 95.43 ± 32.22 minutes (-value = 0.164). Meanwhile, in terms of console time, that for MP was 70.95 ± 21.92 minutes whereas that for SP was 64.14 ± 32.06 minutes (-value = 0.248). In terms of estimated blood loss was 90.91 ± 91.06 mL in MP and 92.27 ± 104.30 mL in SP (-value = 0.948). Lastly, there was a statistically significant difference in warm ischemic time, as it was 17.18 ± 6.56 minutes in MP and 13.82 ± 4.59 in SP (-value = 0.007). There were no statistically significant differences between MP and SP in any other surgical outcomes. SP robot RP PNx demonstrated comparable outcomes to those achieve using MP procedures. This means SP robot RP PNx can be considered a preferable and more convenient surgical approach than conventional methods, particularly when dealing with small renal masses located in the posterior side of the kidney.
为比较使用单端口机器人（SP）或多端口机器人（MP）进行腹膜后（RP）机器人部分肾切除术（PNx）的手术结果。我们回顾性分析了2021年9月（该机构引入SP机器人时）至2023年4月在单一机构进行的所有RP机器人PNx手术。共有125例患者接受了手术；81例患者采用MP机器人进行手术，而44例患者采用SP进行手术。所有MP手术均使用达芬奇Xi系统（直观外科公司，美国加利福尼亚州桑尼维尔）进行，而所有SP手术均使用达芬奇SP系统（直观外科公司，美国加利福尼亚州桑尼维尔）进行。我们对这125例患者进行了倾向评分匹配（PSM）分析。PSM后两组之间无显著差异。在手术时间方面，MP组为103.68±21.89分钟，而SP组为95.43±32.22分钟（P值=0.164）。同时，在控制台操作时间方面，MP组为70.95±21.92分钟，而SP组为64.14±32.06分钟（P值=0.248）。MP组估计失血量为90.91±91.06 mL，SP组为92.27±104.30 mL（P值=0.948）。最后，在热缺血时间上存在统计学显著差异，MP组为17.18±6.56分钟，SP组为13.82±4.59分钟（P值=0.007）。在任何其他手术结果方面，MP组和SP组之间均无统计学显著差异。SP机器人RP PNx的手术结果与MP手术相当。这意味着SP机器人RP PNx可被视为比传统方法更可取、更方便的手术方式，尤其是在处理位于肾脏后侧的小肾肿块时。
