■专门构建的SHURUI单端口(SP)机器人平台最近已被引入泌尿科的几种程序,普外科,和妇科。然而,缺乏与达芬奇SP等早期模型相关的性能比较证据。我们的目的是比较SHURUISP和daVinciSP机器人之间根治性前列腺切除术(RP)的逐步技术和1年结果。
■数据是从两个前瞻性维护的数据库中检索的。在中国(2021年9月至2022年8月)使用SHURUISP机器人对34例患者进行RP;在美国(2019年6月至2020年10月)使用daVinciSP机器人连续进行100例RP病例。进行了年龄1:1倾向评分匹配前后的比较分析,身体质量指数,美国泌尿外科协会症状评分,前列腺大小,前列腺特异性抗原(PSA)水平,活检分级组,和D\'Amico风险组。比较两组之间的术中表现以及短期肿瘤和尿失禁结果。生化复发定义为连续两次术后PSA水平>0.2ng/ml。连续被定义为在不使用垫的情况下完全恢复尿液控制。Kaplan-Meier方法用于估计失禁恢复曲线,并采用趋势对数秩检验来检测术后SHURUISP组和daVinciSP组之间尿失禁恢复的有序差异。
■对于匹配的舒瑞和达芬奇组,中位年龄(69岁vs69岁),PSA中位数(8.4比7.1ng/ml),低危患者比例(33.3%vs29.6%),中等风险(66.7%对63%),和高危疾病(0%vs7.4%)具有可比性(均p>0.05)。所有手术都成功完成,没有转化。在SHURUI组中,较高比例的病例涉及腹膜外途径(81.5%vs0%;p<0.001)和纯SP方法(25.9%vs0%;p=0.01),而达芬奇组接受保留神经手术的病例比例更高。SHURUI组的中位总手术时间(215vs110分钟;p<0.001)和中位控制台时间(162vs75分钟;p<0.001)明显更长。两组均未出现术中或术后严重并发症。手术切缘阳性率(18.5%vs14.8%;p=1.0)和前列腺外延伸率(14.8%vs29.6%;p=0.19)相似。中位随访时间为13.5个月对15.9个月,所有患者均未出现生化复发.手术后1年,两组的失禁率为96.3%。
■尽管两个SP机器人系统之间的驱动机制存在差异,在初始学习阶段,可以使用SHURUIRP机器人安全有效地执行RP,与使用达芬奇SP机器人的患者具有相似的短期肿瘤和尿失禁结果。
■我们比较了两个用于进行机器人手术的手术机器人(SHURUISP和daVinciSP),以通过单个锁孔切口而不是多个切口切除前列腺。我们的结果显示了两种机器人的可比技术以及相似的手术和短期癌症控制结果。
UNASSIGNED: The purpose-built SHURUI single-port (SP) robotic platform has recently been introduced for several procedures in urology, general surgery, and gynecology. However, comparative evidence on its performance in relation to earlier models such as the da Vinci SP is lacking. Our aim was to compare the step-by-step techniques and 1-yr outcomes for radical prostatectomy (RP) between the SHURUI SP and da Vinci SP robots.
UNASSIGNED: Data were retrieved from two prospectively maintained databases. The SHURUI SP robot was used to perform RP in 34 patients in China (September 2021 to August 2022); the da Vinci SP robot was used to perform 100 consecutive RP cases in the USA (June 2019 to October 2020). A comparative analysis was conducted before and after 1:1 propensity score matching for age, body mass index, American Urological Association symptom score, prostate size, prostate-specific antigen (PSA) levels, biopsy grade group, and D\'Amico risk group. Intraoperative performance and short-term oncological and continence outcomes were compared between the groups. Biochemical recurrence was defined as two consecutive postoperative PSA levels >0.2 ng/ml. Continence was defined as full recovery of urinary control without the use of pads. The Kaplan-Meier method was used to estimate continence recovery curves, and a log-rank test for trend was used to detect ordered differences in continence recovery between the SHURUI SP and da Vinci SP groups after surgery.
UNASSIGNED: For the matched SHURUI and da Vinci groups, median age (69 vs 69 yr), median PSA (8.4 vs 7.1 ng/ml), and the proportion of patients with low-risk (33.3% vs 29.6%), intermediate-risk (66.7% vs 63%), and high-risk disease (0% vs 7.4%) were comparable (all p > 0.05). All surgeries were successfully accomplished without conversion. A higher percentage of cases in the SHURUI group involved extraperitoneal access (81.5% vs 0%; p < 0.001) and a pure SP approach (25.9% vs 0%; p = 0.01), while a higher percentage of cases in the da Vinci group had nerve-sparing surgery. The median total operative (215 vs 110 min; p < 0.001) and median console time (162 vs 75 min; p < 0.001) were significantly longer in the SHURUI group. No intraoperative or major postoperative complications were observed in either group. Rates of positive surgical margins (18.5% vs 14.8%; p = 1.0) and extraprostatic extension (14.8% vs 29.6%; p = 0.19) were similar. At median follow-up of 13.5 versus 15.9 mo, none of the patients had experienced biochemical recurrence. At 1 yr after surgery, the continence rate was 96.3% in both groups.
UNASSIGNED: Despite differences in driving mechanisms between the two SP robotic systems, RP can be performed safely and effectively with the SHURUI RP robot during the initial learning phase, with similar short-term oncological and continence outcomes to those with the da Vinci SP robot.
UNASSIGNED: We compared two surgical robots (SHURUI SP and da Vinci SP) used to perform robotic surgery to remove the prostate through a single keyhole incision instead of multiple incisions. Our results show comparable technology and similar surgical and short-term cancer control outcomes for the two robots.