【摘要】 目的:探讨国产多孔腔镜手术机器人(MP1000)在根治性前列腺切除术中的安全性、稳定性和有效性并总结其应用体会。方法:回顾性分析2023年4月—2023年12月于解放军总医院泌尿外科应用多孔腔镜手术机器人(MP1000)行根治性前列腺切除术的所有患者的临床资料，并对纳入患者进行为期1年的随访。随访内容包括尿管留置时长、术后并发症、尿控恢复、生化复发等情况。尿控恢复定义为：每日不使用尿垫且无漏尿/仅用1块安全尿垫。生化复发定义为：术后总前列腺特异性抗原(total prostate-specific antigen, tPSA)降至检测水平以下(<0.1 ng/mL)后，连续2次随访tPSA>0.1 ng/mL且呈上升趋势。采用SPSS 22.0统计并分析患者围手术期资料及随访资料。结果:共纳入65例患者，年龄为68.0(62.0,72.0)岁、体重指数(BMI)为24.0(22.8,26.6) kg/m~2,前列腺体积为33.0(24.3,43.3) mL,tPSA为13.0(9.7,27.2) ng/mL,术前行内分泌治疗13例。临床T2期57例，T3期7例，T4期1例。Gleason评分6分6例，7分33例，≥8分26例。所有患者无二次手术、中转开腹等记录。手术时间为165(125,190) min,估计失血量为100(50,100) mL,切缘阳性率为30.8%(20/65)。术后1年生化复发率为7.7%(5/65)。术中、术后均未输血，术后总并发症发生率为13.8%(9/65),其中早期并发症发生率为7.7%(5/65),远期并发症发生率为6.2%(4/65)。术后即刻尿控恢复率为26.2%(17/65),短期(术后3个月)尿控恢复率为75.4%(49/65),远期(术后12个月)尿控恢复率为95.4%(62/65)。结论:单中心初步经验显示多孔腔镜手术机器人(MP1000)在泌尿外科根治性前列腺切除术中安全性、稳定性较好，患者肿瘤控制和术后功能恢复结局满意，具有良好的临床推广应用价值。更多还原

【Abstract】 Objective: To evaluate the safety, stability, and efficacy of the domestic multi-port laparoscopic surgical robot system(MP1000) in radical prostatectomy and to summarize its clinical application experience. Methods: We retrospectively analyzed the clinical data of patients who underwent radical prostatectomy using the multi-port laparoscopic surgical robot system(MP1000) at the Chinese PLA General Hospital between April 2023 and December 2023. All included patients were followed up for one year. Follow-up assessments included duration of catheterization, postoperative complications, recovery of urinary continence, and biochemical recurrence. Urinary continence was defined as requiring no pads or only one safety pad per day without leakage. Biochemical recurrence was defined as two consecutive rises in postoperative tPSA levels >0.1 ng/mL after initially falling below detectable levels(<0.1 ng/mL). Perioperative and follow-up data were summarized and analyzed using SPSS 22.0. Results: A total of 65 patients were included, with a median age of 68.0(62.0, 72.0) years, BMI of 24.0(22.8, 26.6) kg/m~2, prostate volume of 33.0(24.3, 43.3) mL, and tPSA of 13.0(9.7, 27.2) ng/mL. Thirteen patients received preoperative endocrine therapy. Clinical staging included 57 cases of T2, 7 cases of T3, and 1 case of T4. Gleason scores were 6 in 6 patients, 7 in 33 patients, and ≥8 in 26 patients. No cases required reoperation or conversion to open surgery. The median operative time was 165(125, 190) minutes, with an estimated blood loss of 100(50, 100) mL. The positive surgical margin(PSM) rate was 30.8%(20/65). The one-year biochemical recurrence rate was 7.7%(5/65). No blood transfusions were required during or after surgery. The overall postoperative complication rate was 13.8%(9/65), including 7.7%(5/65) early complications and 6.2%(4/65) late complications. The immediate postoperative urinary continence recovery rate was 26.2%(17/65), the short-term(3 months) recovery rate was 75.4%(49/65), and the long-term(12 months) recovery rate was 95.4%(62/65). Conclusion: Initial single-center experience demonstrates that the multi-port laparoscopic surgical robot system(MP1000) exhibits favorable safety and stability in radical prostatectomy. Patients achieved satisfactory outcomes in terms of tumor control and functional recovery, indicating promising clinical applicability and value for broader adoption.更多还原