Erdemoglu Evrim, Galasso Francesca I, Mourad Jamal, Butler Kristina, Magrina Javier, Yi Johnny
Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, AZ, USA.
Department of Obstetrics and Gynecology, Suleyman Demirel University, Isparta, Turkey.
J Robot Surg. 2025 Jun 24;19(1):323. doi: 10.1007/s11701-025-02499-8.
There is limited published data evaluating the safety of the da-Vinci-SP1098 platform and only a few utilize the Clavien-Dindo Classification (CDC). Comprehensive complication index (CCI) is developed to overcome the restrictions of the CDC. We aimed to compare the perioperative outcomes of hysterectomy for benign disease with the da-Vinci-SP1098 platform (SPORT-SP-H) with the multiport-XI-hysterectomy (MP-Xi-H).
We conducted a retrospective cohort study incorporating a total of 96 patients at a tertiary academic center. Parameters included demographic features, Charlson comorbidity index, Surgical APGAR, indications, and concurrent procedures. Perioperative outcomes included CCI score, CDC grade, length of operation, estimated blood loss, intraoperative complications, length of stay, and conversion rate, sequelae, failure to cure, reoperation and emergency department visit within 1 month. Univariate and multivariate analysis for CCI, CDC and operation duration was undertaken.
Demographic factors were similar. Charlson's comorbidity index (B = 1.43, 95% CI 0.17-2.6, p = 0.02) was found to be the only independent predictor of CCI in the multivariate analysis. There were no grade IV or higher CDC postoperative complications. Except CDC grade I, all were similar between the cohorts. Operation time was significantly longer in SPORT-SP-H (178, r 85-258) compared to MP-Xi-H (123.5, r 74-218, p < 0.0001). Length of hospital stay and other parameters were comparable between the groups (p > 0.05). Independent predictors of longer operation time were SPORT-SP-H, uterine weight and concurrent procedures.
SPORT-SP-Hysterectomy (SP1098) appears to be an alternative to multiport robotic hysterectomy but with a longer operating time. Morbidity is related to surgical complexity and patient comorbidities rather than the robotic platform.
关于达芬奇SP1098平台安全性的已发表数据有限，且仅有少数研究采用了Clavien-Dindo分类法（CDC）。综合并发症指数（CCI）的开发旨在克服CDC的局限性。我们旨在比较使用达芬奇SP1098平台进行良性疾病子宫切除术（SPORT-SP-H）与多端口XI子宫切除术（MP-Xi-H）的围手术期结果。
我们在一家三级学术中心进行了一项回顾性队列研究，共纳入96例患者。参数包括人口统计学特征、Charlson合并症指数、手术阿普加评分、手术指征和同期手术。围手术期结果包括CCI评分、CDC分级、手术时长、估计失血量、术中并发症、住院时长、转化率、后遗症、未治愈情况、再次手术以及术后1个月内的急诊就诊情况。对CCI、CDC和手术时长进行了单因素和多因素分析。
人口统计学因素相似。在多因素分析中，Charlson合并症指数（B = 1.43，95%可信区间0.17 - 2.6，p = 0.02）被发现是CCI的唯一独立预测因素。没有IV级或更高等级的CDC术后并发症。除了CDC I级，两组之间的所有其他情况均相似。与MP-Xi-H（123.5，范围74 - 218）相比，SPORT-SP-H的手术时间明显更长（178，范围85 - 258，p < 0.0001）。两组之间的住院时长和其他参数具有可比性（p > 0.05）。手术时间较长的独立预测因素是SPORT-SP-H、子宫重量和同期手术。
SPORT-SP-H子宫切除术（SP1098）似乎是多端口机器人子宫切除术的一种替代方法，但手术时间更长。发病率与手术复杂性和患者合并症有关，而非机器人平台。
Zotero 插件