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Título

SINGLE PORT RADICAL PROSTATECTOMY COMPARING SHURUI® SP AND DA VINCI® SP ROBOTS: TECHNOLOGY ILLUSTRATION, INTRAOPERATIVE PERFORMANCE AND SURGICAL OUTCOMES

Resumo

Background: Application of the SHURUI® single-port purpose-built robotic platform for various procedures in urology, general surgery and gynecology has been recently described. However, the comparative performance in relation to earlier models such as the da Vinci® SP is still lacking. We aim to compare the step-by-step technique and one-year outcomes between SHURUI® SP and da Vinci® SP robots for patients undergoing radical prostatectomy (RP). Methods: data were retrieved from two prospectively maintained databases. The SHURUI® SPRP was used for 34 patients in China (September 2021 to August 2022), and the da Vinci® SPRP from a single surgeon’s series of 100 consecutive cases in the USA (June 2019 to October 2020). Comparative study was done before and after 1:1 propensity score (PS) matching using the covariates age, body mass index, American Urological Association symptom score, prostate size, prostate-specific antigen levels, biopsy ISUP grade group, and D’Amico risk group. Results: all SP surgeries were finished successfully without alternative conversions. The SHURUI® SP group had a significantly higher percentage of extraperitoneal access and pure single-port approach, with a lower percentage of nerve sparing than the da Vinci® SP group. The median total operative time and median console time were both significantly longer in the SHURUI® SP group. No intra- or major postoperative complications were reported in either group. None of the patients experienced biochemical recurrence during follow-up. Positive surgical margin rates and extraprostatic extension frequencies were similar. The log-rank test for trend revealed the no significant correlations between surgical approach (SHURUI® SP vs. da Vinci® SP) and continence recovery probability. Conclusions: despite differences in technology of driven mechanism between the two robotic SP systems, SHURUI® SPRP can be performed safely and effectively during the initial learning phase with similar short-term functional (continence) and oncological outcomes compared to the da Vinci® SPRP.

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