国产手术机器人与达芬奇手术机器人在肾肿瘤肾部分切除术中的应用效果比较  

Comparison of the application effects of domestically-produced surgical robot and da Vinci surgical robot in partial nephrectomy for renal tumors

作　　者：马涛[1] 刘志伟 安丰[1] 崔振宇[1] 高超 张伟[1] 索勇[1] 宋士超[1] 李锴 MA Tao;LIU Zhiwei;AN Feng;CUI Zhenyu;GAO Chao;ZHANG Wei;SUO Yong;SONG Shichao;LI Kai(Department of Urology,Affiliated Hospital of Hebei University,Hebei Baoding 071000,China)

机构地区：[1]河北大学附属医院泌尿外科,河北保定071000

出　　处：《现代肿瘤医学》2025年第3期448-452,共5页Journal of Modern Oncology

基　　金：河北省政府资助临床医学优秀人才培养项目(编号:ZF2023233)。

摘　　要：目的:比较国产手术机器人与达芬奇手术机器人肾部分切除术的安全性和有效性。方法:回顾性分析2023年04月至2023年12月于我院接受机器人辅助腹腔镜肾部分切除术的患者的临床资料,纳入标准:(1)术前影像学提示肾脏肿瘤;(2)肾肿瘤为单发的T_(1a)N_(0)M_(0)或T_(1b)N_(0)M_(0)期肿瘤;(3)由同一术者和助手,采取机器人辅助腹腔镜肾部分切除术的方式完成;(4)RENAL评分≤9分;(5)签署知情同意书并能够遵嘱定期复诊回访者。排除标准:(1)术前影像学提示多发肾肿瘤者;(2)术前影像学提示有远处转移者;(3)一般检查提示有严重的心、肝、肾功能不全,而无法耐受手术者;(4)临床病例资料不完整者。收集患者的临床及围手术期等资料。结果:本研究共纳入33例患者,其中国产组共14例患者,达芬奇组共19例患者;国产组与达芬奇组患者年龄[(58.00±11.47)岁与(61.84±12.09)岁]、性别(男性79%与68%)、BMI[(26.15±3.47)kg/m^(2)与(26.49±4.47)kg/m^(2)]、RENAL评分[(5.36±1.50)与(5.89±1.20)]、肿瘤最大直径[(2.75±1.04)cm与(2.95±1.08)cm]、中位术中出血量[50(30,50)mL与20(20,50)mL]、术后24 h内血肌酐变化值[(13.50±9.31)μmol/L与(13.68±10.34)μmol/L]、术后引流管拔出时间[(3.43±0.85)d与(3.63±0.76)d]、中位术后住院时间[5(5,7)d与5(5,6)d]比较无明显差异,国产组相比达芬奇组中位手术时间显著延长[182.5(157.5,205.0)min与110.0(95,155)min],两组手术均顺利完成,无中转开放病例,无手术并发症。术后病理结果均为恶性,且标本切缘均为阴性。结论:在肾肿瘤肾部分切除手术的应用中,国产机器人相比达芬奇机器人具有同样理想的手术安全性和有效性,总体而言,国产机器人在机器人辅助腹腔镜下肾部分切除术中具有一定的临床应用价值。Objective:To compare the safety and effectiveness of renal partial nephrectomy(RPN) performed using domestic robot versus da Vinci robot.Methods:A retrospective analysis was conducted on clinical data from patients who underwent robot-assisted laparoscopic partial nephrectomy(RALPN) at our hospital between April 2023and December 2023.Inclusion criteria:(1)Preoperative imaging indicating renal tumors.(2)Single T_(1a)N_0M_(0) or T_(1b)N_0M_(0stage) renal tumors.(3)RALPN performed by the same surgeon and assistant.(4)RENAL score≤9.(5)Signed informed consent and ability to comply with regular follow-up visits.Exclusion criteria.(1)Preoperative imaging indicating multiple renal tumors.(2)Preoperative imaging suggesting distant metastasis.(3)Severe cardiac,hepatic,or renal insufficiency indicated by general examinations,rendering the patient unable to tolerate surgery.(4)Incomplete clinical case data.Clinical and perioperative data were collected from the patients.Results:A total of 33 patients were included in this study,with 14 patients in the domestic robot group and 19 patients in the da Vinci group.There were no significant differences between the domestic and da Vinci groups in terms of patient age [(58.00±11.47) years vs(61.84±12.09) years],gender(79% males vs 68% males),BMI [(26.15±3.47) kg/m^(2) vs(26.49±4.47)kg/m2],RENAL score [(5.36±1.50) vs(5.89±1.20)],maximum tumor diameter [(2.75±1.04) cm vs(2.95±1.08) cm],median intraoperative blood loss [50(30,50) mL vs 20(20,50) mL],change in serum creatinine within 24 hours postoperatively [(13.50±9.31) μmol/L vs(13.68±10.34) μmol/L],postoperative drain removal time [(3.43±0.85) days vs(3.63±0.76) days],and median postoperative hospital stay [5(5,7) days vs 5(5,6) days].However,the median operative time was significantly longer in the domestic robot group compared to the da Vinci group [182.5(157.5,205.0) minutes vs 110.0(95,155) minutes].All surgeries were successfully completed without conversion to open procedures or surgical complications.Postopera

关 键 词：肾癌 国产机器人 安全性 有效性 

分 类 号：R737.11[医药卫生—肿瘤]