Introduction: The Da Vinci Single-Port (DV-SP) system emerged in 2018 but there is limited evidence on its use and perioperative outcomes for robot-assisted adrenalectomy (RAA). Methods: A systematic search was performed through PubMed, Scopus, Ovid, and WoS in December 2024. A PICO framework was used. Population: adult patients with adrenal masses; Intervention: DV-SP RAA; Outcomes: feasibility, reproducibility and safety of DV-SP RAA. A total of five retrospective studies involving 342 patients were included. The quantitative analysis was conducted using a random-effect model or a fixed-effect model as appropriate. A risk of bias assessment for non-randomized comparative studies and case series was performed. Results: The pooled mean operative time was 92.5 min (95% confidence interval [CI] 71.2, 113.9,pI2= 0%, four studies), and the mean estimated blood loss (EBL) was 26.5 mL (95%CI −8.1, 61.2, I2= 98.2%, three studies). Most of the procedures were completed with a single incision, though some required additional port placement, with a proportion of 9% (95%CI 0, 29, I2= 71.7%, five studies). Perioperative complications were rare (0%, 95% CI 0, 4, I2= 0%, five studies). Two studies comparing DV-SP and DV multi-port (MP) found no significant differences in complications. One study compared DV-SP RAA to DV Si or Xi single-access procedures. DV-SP showed improved operative techniques and better cosmetic outcomes. Limitations of this study are small sample size and potential selection bias due to smaller masses in the DV-SP RAA group. Conclusions: DV-SP RAA is a promising approach, offering reduced operative time, low EBL, and excellent cosmetic results. This study shows that DV-SP RAA seems reproducible, feasible, and safe. Limitation of the included studies are small sample size and selection bias, which limits the generalizability of the results. Randomized comparative studies between DV-SP and MP RAA are needed to further validate these findings.
引言：达芬奇单孔（DV-SP）系统于2018年问世，但其在机器人辅助肾上腺切除术（RAA）中的应用及围手术期结局的相关证据有限。方法：于2024年12月通过PubMed、Scopus、Ovid和WoS数据库进行系统性检索，采用PICO框架。研究对象：肾上腺占位性病变的成年患者；干预措施：DV-SP RAA；结局指标：DV-SP RAA的可行性、可重复性及安全性。共纳入5项回顾性研究，涉及342例患者。根据适用情况采用随机效应模型或固定效应模型进行定量分析，并对非随机对照研究及病例系列进行偏倚风险评估。结果：汇总平均手术时间为92.5分钟（95%置信区间[CI] 71.2-113.9，I²=0%，4项研究），平均估计失血量为26.5毫升（95%CI -8.1-61.2，I²=98.2%，3项研究）。多数手术通过单一切口完成，但9%的病例需增加辅助切口（95%CI 0-29，I²=71.7%，5项研究）。围手术期并发症罕见（0%，95%CI 0-4，I²=0%，5项研究）。两项比较DV-SP与DV多孔（MP）技术的研究显示并发症发生率无显著差异。一项研究对比了DV-SP RAA与DV Si或Xi单通道术式，发现DV-SP在手术技术和美容效果方面更具优势。本研究的局限性在于样本量较小，且DV-SP RAA组因肿瘤体积较小可能存在选择偏倚。结论：DV-SP RAA是一种前景广阔的手术方式，具有缩短手术时间、减少术中出血及良好美容效果的优点。研究表明DV-SP RAA具备可重复性、可行性及安全性。现有研究的局限性在于样本量不足和选择偏倚，影响了结果的普适性。未来需开展DV-SP与MP RAA的随机对照研究以进一步验证这些发现。
肿瘤(癌症)患者之家