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单孔机器人在肾切除术中的短期疗效与安全性比较分析

Comparative short-term efficacy and safety analysis of a single-port robot in nephrectomy.

作者信息

Fan Gen, Wang Junji, Wang Yu, Chen Yushui, Wu Yinyu, Cai Songzhi, Li Yang, Tang Tielong

机构信息

Department of Urology, School of Clinical Medicine, North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, No. 1, South Maoyuan Road, Shunqing District, Nanchong City, 63700, Sichuan Province, China.

Jintang First People's Hospital, West China Hospital Sichuan University Jintang Hospital, Chengdu, 610000, Sichuan, China.

出版信息

J Robot Surg. 2025 Apr 24;19(1):175. doi: 10.1007/s11701-025-02343-z.

Abstract

The objective of the study is to conduct a systematic assessment of the clinical effectiveness differences between single-port and multi-port robotic surgical systems in the context of renal tumor removal, grounded in evidence-based medical data. Adhering to PRISMA standards, a comprehensive literature search was executed across PubMed, Embase, Cochrane Library, and Web of Science from their inception until March 2025. The search included randomized controlled trials and cohort studies that compared single-port and multi-port robotic systems for partial or radical nephrectomy. Statistical analysis of the outcomes was carried out using Stata 15.0, with the results presented as weighted mean difference (WMD) and odds ratio (OR). Subgroup analyses were conducted to examine the consistency of the findings with respect to thermal ischemia duration. A combined analysis of 11 studies, comprising 1729 participants, were analyzed, with 654 individuals in the single-port cohort and 1075 in the multi-port cohort. The meta-analysis revealed a significantly shorter hospital stay for the single-port cohort compared to the multi-port cohort (WMD = -0.32, 95% CI -0.47, -0.17, p < 0.05). However, the single-port cohort also experienced a longer thermal ischemia time (WMD = 2.92, 95% CI 0.45, 5.38, p < 0.05). No statistically significant differences were found between the two cohorts regarding complication rates, intraoperative blood loss, operative time, positive margin rates, conversion rates, or tumor recurrence rates. Single-port robotic nephrectomy for renal tumors can enhance postoperative recovery without compromising oncologic safety. Nevertheless, its effect on renal function preservation requires careful evaluation. Future investigations ought to encompass extended, high-caliber studies to offer more substantial data for clinical choices.

摘要

本研究的目的是基于循证医学数据,对单孔与多孔机器人手术系统在肾肿瘤切除方面的临床疗效差异进行系统评估。按照PRISMA标准,从PubMed、Embase、Cochrane图书馆和Web of Science数据库创建至2025年3月进行了全面的文献检索。检索包括比较单孔和多孔机器人系统进行部分或根治性肾切除术的随机对照试验和队列研究。使用Stata 15.0对结果进行统计分析,结果以加权平均差(WMD)和比值比(OR)表示。进行亚组分析以检验关于热缺血持续时间的研究结果的一致性。对11项研究进行了综合分析,共纳入1729名参与者,其中单孔队列654人,多孔队列1075人。荟萃分析显示,与多孔队列相比,单孔队列的住院时间显著缩短(WMD = -0.32,95%CI -0.47,-0.17,p < 0.05)。然而,单孔队列的热缺血时间也更长(WMD = 2.92,95%CI 0.45,5.38,p < 0.05)。在并发症发生率、术中失血量、手术时间、切缘阳性率、中转率或肿瘤复发率方面,两个队列之间未发现统计学显著差异。单孔机器人肾肿瘤切除术可促进术后恢复,且不影响肿瘤学安全性。然而,其对肾功能保留的影响需要仔细评估。未来的研究应包括更广泛、高质量的研究,以提供更多实质性数据用于临床决策。

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