Journal of Robotic Surgery最新文献_第10页

Systematic review and meta-analysis of ROSA vs. conventional therapy for intracerebral hemorrhage. ROSA 与传统疗法治疗脑出血的系统回顾和荟萃分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-21 DOI: 10.1007/s11701-024-02074-7

Li Luo, Chuan-Long He, Wei Li, Xiao-Ping Tang

{"title":"Systematic review and meta-analysis of ROSA vs. conventional therapy for intracerebral hemorrhage.","authors":"Li Luo, Chuan-Long He, Wei Li, Xiao-Ping Tang","doi":"10.1007/s11701-024-02074-7","DOIUrl":"10.1007/s11701-024-02074-7","url":null,"abstract":"The purpose of this systematic review and meta-analysis was to evaluate the perioperative and short-term results of the Robot of Stereotactic Assistance (ROSA) compared to traditional approaches in individuals with intracerebral hemorrhage (ICH). We will perform a comprehensive computerized search of PubMed, CNKI, Embase, and Google Scholar to identify relevant literature on ROSA vs. conventional therapy for intracerebral hemorrhage, covering publications from the inception of each database until July 2024. This study will include both English and Chinese language studies. Literature screening will adhere strictly to inclusion and exclusion criteria, focusing on randomized controlled trials (RCTs) and cohort studies. The ROBINS-I tool is utilized for evaluating bias risk in non-RCTs. Analysis of the data from the studies included will be conducted with Review Manager 5.4.1. The final analysis included 7 retrospective cohort studies and 1 randomized controlled study, involving a total of 844 patients. Among these, 433 patients underwent ROSA, while 411 received conventional treatment (conservative treatment, conventional craniotomy, or stereotactic frame-assisted surgery). Compared to conventional therapy, patients treated with ROSA showed improvements in operative time, postoperative rebleeding, postoperative extubation time, and intracranial infection. Nonetheless, there was no notable contrast in mortality or central hyperthermia outcomes between the two treatments. ROSA is a safe and viable option for treating patients with cerebral hemorrhage, showing significant advantages in terms of surgery duration, postoperative rebleeding, time to remove the breathing tube, and intracranial infection compared to conservative treatment, traditional craniotomy, or stereotactic surgery.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"326"},"PeriodicalIF":2.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

On-clamp vs off-clamp robot-assisted partial nephrectomy for achieving modified trifecta: inverse probability of treatment weighting analysis from a high-volume tertiary robotic center. 钳上与钳下机器人辅助肾部分切除术实现改良三连胜：来自一家大容量三级机器人中心的逆治疗概率加权分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-21 DOI: 10.1007/s11701-024-02078-3

Mario Belmonte, Nicola Frego, Marco Ticonosco, Alessandro Pissavini, Eleonora Balestrazzi, Gabriele Sorce, Francesco Barletta, Silvia Rebuffo, Claudia Collà Ruvolo, Simone Morra, Edward Lambert, Ruben De Groote, Geert De Naeyer, Alexandre Mottrie

{"title":"On-clamp vs off-clamp robot-assisted partial nephrectomy for achieving modified trifecta: inverse probability of treatment weighting analysis from a high-volume tertiary robotic center.","authors":"Mario Belmonte, Nicola Frego, Marco Ticonosco, Alessandro Pissavini, Eleonora Balestrazzi, Gabriele Sorce, Francesco Barletta, Silvia Rebuffo, Claudia Collà Ruvolo, Simone Morra, Edward Lambert, Ruben De Groote, Geert De Naeyer, Alexandre Mottrie","doi":"10.1007/s11701-024-02078-3","DOIUrl":"https://doi.org/10.1007/s11701-024-02078-3","url":null,"abstract":"On-clamp partial nephrectomy for the surgical treatment of renal masses poses the risk of ischemia and greater post-operative renal function loss. Conversely, the off-clamp technique might enhance renal function preservation by avoiding any ischemia time. Nevertheless, the debate persists regarding the efficacy of the on- versus off-clamp partial nephrectomy in achieving better surgical, functional, and oncological outcomes. We retrospectively assessed the data from patients undergoing Robot-Assisted Partial Nephrectomy (RAPN) from 2016 and 2023 in a tertiary robotic center. Inverse probability of treatment weighting (IPTW) was used to account for selection bias in treatment allocation. The main objective of the study was assessing the achievement rates of a modified trifecta within the two groups. Multivariable logistic regression analysis (MLRA) was employed to assess the predictors of trifecta achievement. 532 patients were included in the analysis, of whom 74.1% vs. 25.9% underwent on- and off-clamp, respectively. Balancing the two groups for the main predictors of on-clamp surgery, there were no significant differences between on- and off-clamp in terms of estimated blood loss, transfusion rate, intra- and post-operative complications, positive surgical margins, and post-operative mean reduction of eGFR. Finally, no differences were found in the rate of \"trifecta\" achievement between on-clamp and off-clamp RAPN (24.6% vs. 21%, p = 0.82). At MLRA, off-clamp technique was not a predictor of trifecta achievement compared to the on-clamp technique (off-clamp vs. on-clamp, aOR 1.24, 95% CIs [0.65-2.36], p = 0.58). Our study revealed that clamping technique does not imply clinically relevant differences in reaching trifecta outcomes.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"327"},"PeriodicalIF":2.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low ligation of the inferior mesenteric artery in robotic mid-low rectal cancer surgery: a comparative study from a single-center. 机器人中低位直肠癌手术中肠系膜下动脉的低位结扎：一项来自单一中心的比较研究。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-21 DOI: 10.1007/s11701-024-02080-9

Chenkai Zhang, Yayan Fu, Ruiqi Li, Jie Wang, Dong Tang, Jun Ren, Daorong Wang, Wenzhang Zha

{"title":"Low ligation of the inferior mesenteric artery in robotic mid-low rectal cancer surgery: a comparative study from a single-center.","authors":"Chenkai Zhang, Yayan Fu, Ruiqi Li, Jie Wang, Dong Tang, Jun Ren, Daorong Wang, Wenzhang Zha","doi":"10.1007/s11701-024-02080-9","DOIUrl":"https://doi.org/10.1007/s11701-024-02080-9","url":null,"abstract":"Laparoscopic total mesorectal excision is the main surgical approach for treating rectal cancer, but there is still no clear consensus on the issue of low ligation of the inferior mesenteric artery during the procedure. Robotic surgery has been shown to have certain advantages over laparoscopic surgery in multiple studies, but further research is needed to better understand the outcomes of robotic surgery in the context of low ligation procedures. In this study, we included 1590 patients with mid-low rectal cancer. Among them, 942 patients underwent low ligation surgery (LL), divided into 138 in the robotic group and 804 in the laparoscopic group. The high ligation surgery (HL) group consisted of 648 patients. The results of LL vs HL showed that the LL group had faster bowel movement recovery (P = 0.003), lower anastomotic leak rate (P = 0.032), and lower International Prostate Symptom Score (IPSS) at 6 months postoperatively (P < 0.001). The results of Rob-LL vs Lap-LL showed that the Rob-LL group had longer operative time (P < 0.001), less blood loss (P = 0.001), more lymph nodes retrieved (P = 0.045), and lower Wexner score at 2 weeks postoperatively (P = 0.029). The concept of low ligation of the inferior mesenteric artery is a promising surgical approach that can accelerate the patient's functional recovery. When combined with robotic technology, it may offer more benefits than laparoscopic techniques.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"325"},"PeriodicalIF":2.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-assisted versus conventional neck dissection: a propensity score matched case-control study on perioperative and oncologic outcomes. 机器人辅助与传统颈部切除术：关于围手术期和肿瘤学结果的倾向得分匹配病例对照研究。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-17 DOI: 10.1007/s11701-024-02079-2

Hyounmin Kim, Taegyeong Oh, In-Ho Cha, Hyung Jun Kim, Woong Nam, Dongwook Kim

{"title":"Robot-assisted versus conventional neck dissection: a propensity score matched case-control study on perioperative and oncologic outcomes.","authors":"Hyounmin Kim, Taegyeong Oh, In-Ho Cha, Hyung Jun Kim, Woong Nam, Dongwook Kim","doi":"10.1007/s11701-024-02079-2","DOIUrl":"https://doi.org/10.1007/s11701-024-02079-2","url":null,"abstract":"The widespread acceptance of robotic surgery is extending to oral procedures. The demand for minimally invasive techniques is driving research into the cosmetic and oncologic benefits of robotic neck surgery. This study used propensity score matching to analyze the clinical course and postoperative outcomes of robot-assisted neck dissections for oncologic efficacy and surgical safety. Between May 2020 and April 2024, 200 OSCC patients underwent surgery and 42 were excluded. The cohort included 158 patients, 128 of whom underwent unilateral neck dissection and 30 of whom underwent bilateral neck dissection. Robotic-assisted neck dissection (RAND) was performed in 36 patients while conventional transcervical neck dissection (CTND) was performed in 122 patients. Data analysis included several factors, including lymph node retrieval and perioperative outcomes, with 1:1 propensity score matching to ensure fairness. Each of the 39 neck specimens with 36 patients was selected. The CTND group was 8 years older overall than the RAND group, but otherwise similar in terms of primary site and clinical stage. The RAND group had a 55-min longer operative time and 140 cc more hemovac drainage than the CTND group, but the hospital stay and intensive care unit duration were the same, and the number of lymph nodes retrieved was the same. Survival rates also showed no difference across all stages. This shows that RAND is in no way inferior to CTND in terms of perioperative or oncologic outcomes, and demonstrates the safety of robot-assisted surgery, even in patients who require flaps or in patients with advanced stages.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"323"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simulation-based training in robotic surgery education: bibliometric analysis and visualization. 机器人手术教育中的模拟培训：文献计量分析与可视化。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-17 DOI: 10.1007/s11701-024-02076-5

Siwei Chen, Jingjuan Huang, Lin Zhang, Yanwen Xu, Zeyong Zhang

{"title":"Simulation-based training in robotic surgery education: bibliometric analysis and visualization.","authors":"Siwei Chen, Jingjuan Huang, Lin Zhang, Yanwen Xu, Zeyong Zhang","doi":"10.1007/s11701-024-02076-5","DOIUrl":"https://doi.org/10.1007/s11701-024-02076-5","url":null,"abstract":"Simulation-based robotic surgery training may help surgeons gain operative skills and experience in the simulation environment. This bibliometric analysis examined the development of simulation-based training for robotic surgical education. Articles pertaining to robotic surgical simulation training that were included in the Web of Science Core Collection up to April 25, 2024, were included. The temporal patterns in published paper numbers were evaluated using Microsoft Excel software, and the data regarding co-authorship and keyword co-occurrence were analyzed and visualized using the VOSviewer and SCImago Graphica tools. A total of 594 papers on simulation-based training for robotic surgical education were evaluated in this study. The United States and United Kingdom were the leading contributors in this field. The most published authors were Professor Ahmed Kamran (23 publications) and Prokar Dasgupta (22 publications). The highest number of papers was published in the journal titled \"Surgical Endoscopy and Other Interventional Techniques.\" The most common keywords were \"virtual reality,\" \"curriculum,\" \"robotic surgery simulator,\" \"assessment,\" and \"learning curve.\" Our study offers a detailed overview of international research on simulation-based training for robotic surgical education, including the publishing countries, institutions, authors, journals, and research hotspots. It also methodically summarizes the state of knowledge in the area, and provides definite directions and concepts for further in-depth analysis.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"324"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

RoboticSurgery4all: are discovery courses important for robotic surgery skills acquisition? RoboticSurgery4all：探索课程对机器人手术技能的掌握很重要吗？

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-14 DOI: 10.1007/s11701-024-02077-4

Mário Rui Gonçalves, Björn Mück, Jean-Pierre Faure, Philippe Topart, Miguel Castelo-Branco Sousa

{"title":"RoboticSurgery4all: are discovery courses important for robotic surgery skills acquisition?","authors":"Mário Rui Gonçalves, Björn Mück, Jean-Pierre Faure, Philippe Topart, Miguel Castelo-Branco Sousa","doi":"10.1007/s11701-024-02077-4","DOIUrl":"10.1007/s11701-024-02077-4","url":null,"abstract":"Cost, logistics, and availability of robotic simulation opportunities suppose a real challenge for robotic surgery training. We aimed to test a new methodology for introduction to robotic surgery pre-congress courses. Two different \"introduction to robotic surgery\" pre-congress courses were developed. A new methodology using a sleeve/bypass, a ventral TAPP and an inguinal TAPP silicone models was implemented. After the session, the trainees answered a questionnaire to evaluate the course and the methodology using 1-5 Likert scales. A total of 21 participants participated in the courses and (72.2%) had no experience in robotic surgery. All trainees rated the course as good or excellent. There was a strong agreement between participants regarding the adequacy of the silicone models for this type of simulation/course. Trainees agree that the course gave them more confidence to perform a real robotic procedure, increased their interest in robotic surgery and made them feel ready to start their robotic surgery pathway. Congresses are a frequent way of contact between surgeons and robotic systems, mostly in the form of technical demonstrations or pre-congress courses. Our methodology showed that it is possible to allow for this contact in a low-cost way. This kind of courses is well received by congress delegates and have a positive educational impact. Despite of being \"Discovery\" courses, they have a positive impact on the congress, on the acquisition of robotic surgery skills and increase the interest in robotic surgery.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"322"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of single-port versus multi-port robotic assisted partial nephrectomy: a systematic review and meta-analysis of perioperative and oncological outcomes. 单孔与多孔机器人辅助肾部分切除术的比较：围手术期和肿瘤学结果的系统回顾和荟萃分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-13 DOI: 10.1007/s11701-024-02066-7

Anneng Hu, Zongying Lv, Guiyuan Chen, Yuhang Lin, Xiaole Zhu, Junyang Li, Xiaodong Yu

{"title":"Comparison of single-port versus multi-port robotic assisted partial nephrectomy: a systematic review and meta-analysis of perioperative and oncological outcomes.","authors":"Anneng Hu, Zongying Lv, Guiyuan Chen, Yuhang Lin, Xiaole Zhu, Junyang Li, Xiaodong Yu","doi":"10.1007/s11701-024-02066-7","DOIUrl":"https://doi.org/10.1007/s11701-024-02066-7","url":null,"abstract":"The safety and efficacy of single-port and multi-port robot-assisted partial nephrectomy (SP-RAPN and MP-RAPN, respectively) were assessed for treating partial nephrectomy in this study. A systematic review of PubMed, Cochrane Library, and Web of Science databases was conducted up to June 2024 to compare studies on SP-RAPN and MP-RAPN. Primary outcomes included perioperative results, complications, and oncological outcomes. Eight studies involving 1014 patients were analyzed. For binary outcomes, comparisons were performed using odds ratios (OR), and for continuous variables, weighted mean differences (WMD) with 95% confidence intervals (CI). The search failed to discover significant meaningful variations in operating times (p = 0.54), off-clamp procedure (P = 0.36), blood loss (p = 0.31), positive surgical margins (PSMs) (p = 0.78), or major complications (Clavien-Dindo grade ≥ 3) (p = 0.68) between SP-RAPN and MP-RAPN. However, shorter hospital stays (WMD - 0.26 days, 95% CI - 0.36 to - 0.15; p < 0.00001) and longer warm ischemia times (WIT) (WMD 3.13 min, 95% CI 0.81-5.46; p = 0.008) were related to SP-RAPN, and higher transfusion rate (OR 2.99, 95% CI 1.31-6.80; p = 0.009) compared to MP-RAPN. SP-RAPN performed better in terms of hospital stay but had slightly higher rates of transfusion, off-clamp procedures, and warm ischemia time (WIT) compared to MP-RAPN. As an emerging technology, preliminary research suggests that SP-RAPN is a feasible and safe method for carrying out a nephrectomy partial. However, compared to MP-RAPN, it shows inferior outcomes regarding (WIT) and transfusion rates.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"321"},"PeriodicalIF":2.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robotic surgery reduces the consumption of medical consumables: cost analysis of robotic pancreatic surgery from a tertiary hospital in China. 机器人手术减少了医疗耗材的消耗：中国一家三级医院机器人胰腺手术的成本分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-12 DOI: 10.1007/s11701-024-02075-6

Rui Hou, Qiang Xu, Xiaokun Liu, Jingya Zhou, Weiguo Zhu, Weibin Wang

{"title":"Robotic surgery reduces the consumption of medical consumables: cost analysis of robotic pancreatic surgery from a tertiary hospital in China.","authors":"Rui Hou, Qiang Xu, Xiaokun Liu, Jingya Zhou, Weiguo Zhu, Weibin Wang","doi":"10.1007/s11701-024-02075-6","DOIUrl":"https://doi.org/10.1007/s11701-024-02075-6","url":null,"abstract":"Robotic surgery has been increasingly adopted in various surgical fields, but the cost-effectiveness of this technology remains controversial due to its high cost and limited improvements in clinical outcomes. This study aims to explore the health economic implications of robotic pancreatic surgery, to investigate its impact on hospitalization costs and consumption of various medical resources. Data of patients who underwent pancreatic surgery at our institution were collected and divided into robotic and traditional groups. Statistical analyses of hospitalization costs, length of stay, costs across different service categories, and subgroup cost analyses based on age, BMI class, and procedure received were performed using t tests and linear regression. Although the total hospitalization cost for the robotic group was significantly higher than that for the traditional group, there was a notable reduction in the cost of medical consumables. The reduction was more prominent among elderly patients, obese patients, and those undergoing pancreaticoduodenectomy, which could be attributed to the technological advantages of the robotic surgery platform that largely facilitate blood control, tissue protection, and suturing. The study concluded that despite higher overall costs, robotic pancreatic surgery offers significant savings in medical consumables, particularly benefiting certain patient subgroups. The findings provide valuable insights into the economic viability of robotic surgery, supporting its adoption from a health economics perspective.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"320"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robotic pyelolithotomy for treating large renal stone disease: a systematic review and single-arm meta-analysis. 治疗大型肾结石病的机器人肾盂切开术：系统综述和单臂荟萃分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-09 DOI: 10.1007/s11701-024-02064-9

Li Wang, Si-Yu Chen, Fan-Qi Wu, Shun Wan, Kun-Peng Li, Xiao-Ran Li

{"title":"Robotic pyelolithotomy for treating large renal stone disease: a systematic review and single-arm meta-analysis.","authors":"Li Wang, Si-Yu Chen, Fan-Qi Wu, Shun Wan, Kun-Peng Li, Xiao-Ran Li","doi":"10.1007/s11701-024-02064-9","DOIUrl":"https://doi.org/10.1007/s11701-024-02064-9","url":null,"abstract":"Robotic pyelolithotomy continues to gain attention as an alternative to percutaneous nephrolithotomy (PCNL) for managing complex renal stones. We performed a single-arm meta-analysis and systematically searched the English-language literature published in PubMed, Web of Science, Scopus, and Google Scholar databases up to June 2024. The risk of non-randomized bias was assessed using ROBINS-I, and the quality of the literature was assessed using MINORS (Methodological Index for Non-Randomized Studies). Merger parameters were calculated using Stata16/SE under a random-effects model. Five non-comparative single-arm studies were included in the meta-analysis. Results showed that the operative time for robotic pyelolithotomy was 168.10 min (95% CI 133.63, 202.56). The hospital stay was 2.63 days (95% CI 0.96, 4.29), and blood loss was 44.13 ml (95% CI 19.76, 68.51). The stone clearance rate was 87% (95% CI 79-93%). The incidence of minor postoperative complications (Clavien grade I-II) was 23.7% (95% CI 13.4-35.8%), and the incidence of major complications (Clavien grade ≥ III) was 7% (95% CI 0.3-20.7%).The safety and efficacy of robotic pyelolithotomy in treating complex renal stones are acceptable, but future large prospective cohort studies are needed to validate the treatment.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"316"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The prostate-gland asymmetry affects the 3- and 12-month continence recovery after RARP in patients with small prostate glands: a single center study. 前列腺腺体不对称影响小前列腺患者 RARP 术后 3 个月和 12 个月的尿失禁恢复：一项单中心研究。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-08-09 DOI: 10.1007/s11701-024-02024-3

Francesco Di Bello, Simone Morra, Agostino Fraia, Gabriele Pezone, Federico Polverino, Giuliano Granata, Claudia Collà Ruvolo, Luigi Napolitano, Andrea Ponsiglione, Arnaldo Stanzione, Roberto La Rocca, Raffaele Balsamo, Massimiliano Creta, Massimo Imbriaco, Ciro Imbimbo, Nicola Longo, Gianluigi Califano

{"title":"The prostate-gland asymmetry affects the 3- and 12-month continence recovery after RARP in patients with small prostate glands: a single center study.","authors":"Francesco Di Bello, Simone Morra, Agostino Fraia, Gabriele Pezone, Federico Polverino, Giuliano Granata, Claudia Collà Ruvolo, Luigi Napolitano, Andrea Ponsiglione, Arnaldo Stanzione, Roberto La Rocca, Raffaele Balsamo, Massimiliano Creta, Massimo Imbriaco, Ciro Imbimbo, Nicola Longo, Gianluigi Califano","doi":"10.1007/s11701-024-02024-3","DOIUrl":"10.1007/s11701-024-02024-3","url":null,"abstract":"To test the impact of the prostate-gland asymmetry on continence rates, namely 3- and 12-month continence recovery, in prostate cancer (PCa) patients who underwent robot-assisted radical prostatectomy (RARP). Within our institutional database, RARP patients with complete preoperative MRI features and 12 months follow-up were enrolled (2021-2023). The population has been stratified according to the presence or absence of prostate-gland asymmetry (defined as the presence of median lobe or side lobe dominance). Multivariable logistic regression models (LRMs) predicting the continence rate at 3 and 12 months after RARP were fitted in the overall population. Subsequently, the LRMs were repeated in two subgroup analyses based on prostate size (≤ 40 vs > 40 ml). Overall, 248 consecutive RARP patients were included in the analyses. The rate of continence at 3 and 12 months was 69 and 72%, respectively. After multivariable LRM the bladder neck sparing approach (OR 3.15, 95% CI 1.68-6.09, p value < 0.001) and BMI (OR 0.90, 95% CI 0.82-0.97, p = 0.006) were independent predictors of recovery continence at 3 months. The prostate-gland asymmetry independently predicted lower continence rates at 3 (OR 0.33, 95% CI 0.13-0.83, p = 0.02) and 12 months (OR 0.31, 95% CI 0.10-0.90, p = 0.03) in patients with prostate size ≤ 40 ml. The presence of prostate lobe asymmetry negatively affected the recovery of 3- and 12-months continence in prostate glands ≤ 40 mL. These observations should be considered in the preoperative planning and counseling of RARP patients.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"319"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0