{"title":"Comparison between two da vinci surgical systems in trifecta and pentafecta rates for robot-assisted partial nephrectomy","authors":"Chih-Heng Chen, Kuo-How Huang, Shuo‐Meng Wang, Po-Ming Chow, Pei-Ling Chen, Jian-Hua Hong, Chao-yuan Huang","doi":"10.4103/UROS.UROS_172_21","DOIUrl":null,"url":null,"abstract":"Purpose: Comparative studies on the outcomes of robot-assisted partial nephrectomy (RAPN) procedures conducted using the da Vinci Xi and Si platforms remain sparse. We retrospectively reviewed and compared the Trifecta and Pentafecta rates of the two robotic surgical platforms. Materials and Methods: A total of 338 patients who had undergone RAPN using da Vinci Si platform or Xi platform were included. Pentafecta was defined herein as Trifecta (a warm ischemia time <25 min, a negative surgical margin, and the absence of significant perioperative complications) with the addition of estimated glomerular filtration rate preservation of over 90% and no chronic kidney disease stage progression by 12 months postsurgery. Multivariate logistic regression analysis was conducted to identify the predictors of Trifecta and Pentafecta achievement. Results: The trifecta and pentafecta rates were higher in the Xi group than in the Si group (65% vs. 29%, P < 0.001 for trifecta; 31% vs. 14%, P = 0.001 for pentafecta). In addition, a significantly shorter average WIT (19 vs. 28 min, P < 0.001) and console time (141 vs. 163 min, P = 0.004) were identified in the Xi group than in the Si group. RAPN conducted using the Xi platform was independently associated with both higher achievement rates of trifecta and pentafecta. In addition, multivariate regression analyses revealed that no history of hypertension, low tumor complexity as measured using the RENAL nephrometry score, anterior orientation of the renal tumor were associated with higher Trifecta rates; while history of diabetes and anterior–posterior renal tumor orientation were the significant predictors of Pentafecta achievement, respectively. Conclusion: A significantly higher rates of trifecta and pentafecta achievement were observed in the Xi group than in the Si group. The use of the Xi platform was also significantly associated with low operative times and acceptable complication rates.","PeriodicalId":23449,"journal":{"name":"Urological Science","volume":"34 1","pages":"99 - 106"},"PeriodicalIF":0.8000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urological Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/UROS.UROS_172_21","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Comparative studies on the outcomes of robot-assisted partial nephrectomy (RAPN) procedures conducted using the da Vinci Xi and Si platforms remain sparse. We retrospectively reviewed and compared the Trifecta and Pentafecta rates of the two robotic surgical platforms. Materials and Methods: A total of 338 patients who had undergone RAPN using da Vinci Si platform or Xi platform were included. Pentafecta was defined herein as Trifecta (a warm ischemia time <25 min, a negative surgical margin, and the absence of significant perioperative complications) with the addition of estimated glomerular filtration rate preservation of over 90% and no chronic kidney disease stage progression by 12 months postsurgery. Multivariate logistic regression analysis was conducted to identify the predictors of Trifecta and Pentafecta achievement. Results: The trifecta and pentafecta rates were higher in the Xi group than in the Si group (65% vs. 29%, P < 0.001 for trifecta; 31% vs. 14%, P = 0.001 for pentafecta). In addition, a significantly shorter average WIT (19 vs. 28 min, P < 0.001) and console time (141 vs. 163 min, P = 0.004) were identified in the Xi group than in the Si group. RAPN conducted using the Xi platform was independently associated with both higher achievement rates of trifecta and pentafecta. In addition, multivariate regression analyses revealed that no history of hypertension, low tumor complexity as measured using the RENAL nephrometry score, anterior orientation of the renal tumor were associated with higher Trifecta rates; while history of diabetes and anterior–posterior renal tumor orientation were the significant predictors of Pentafecta achievement, respectively. Conclusion: A significantly higher rates of trifecta and pentafecta achievement were observed in the Xi group than in the Si group. The use of the Xi platform was also significantly associated with low operative times and acceptable complication rates.
我们回顾性地回顾并比较了两种机器人手术平台的三趾和五趾率。Pentafecta在这里被定义为三联(热缺血时间<25分钟,手术切缘阴性,无明显围手术期并发症),外加肾小球滤过率估计保存超过90%,术后12个月无慢性肾脏疾病进展。进行多因素logistic回归分析,以确定三联曲和五联曲效果的预测因素。31% vs. 14%, P = 0.001)。此外,多变量回归分析显示,无高血压病史、低肿瘤复杂性(用肾肾测量评分测量)、肾肿瘤的前向与较高的三氟替卡发生率相关;而糖尿病史和前后肾肿瘤取向分别是Pentafecta成就的显著预测因素。