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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2026, Vol. 19 ›› Issue (03) : 146 -152. doi: 10.3877/cma.j.issn.1674-6899.2026.03.005

论著

康多机器人系统与达芬奇机器人系统在"一体位"半尿路切除术中的比较研究
杨文杰, 东洁, 马琳, 纪志刚, 徐维锋†()   
  1. 100005　中国医学科学院/北京协和医学院/北京协和医院泌尿外科
  • 收稿日期:2026-05-24 出版日期:2026-06-30
  • 通信作者: 徐维锋
  • 基金资助:
    国家重点研发计划(2023YFC2413403)

A retrospective comparative study of the KangDuo robotic system and the da Vinci robotic system in single-position robot-assisted laparoscopic radical nephroureterectomy

Wenjie Yang, Jie Dong, Lin Ma, Zhigang Ji, Weifeng Xu†()   

  1. Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
  • Received:2026-05-24 Published:2026-06-30
  • Corresponding author: Weifeng Xu
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引用本文：

杨文杰, 东洁, 马琳, 纪志刚, 徐维锋. 康多机器人系统与达芬奇机器人系统在"一体位"半尿路切除术中的比较研究[J/OL]. 中华腔镜外科杂志(电子版), 2026, 19(03): 146-152.

Wenjie Yang, Jie Dong, Lin Ma, Zhigang Ji, Weifeng Xu. A retrospective comparative study of the KangDuo robotic system and the da Vinci robotic system in single-position robot-assisted laparoscopic radical nephroureterectomy[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2026, 19(03): 146-152.

目的

比较康多手术机器人(KD-SR-01/KD-SR-02)系统与达芬奇手术机器人(Si/Xi)系统在机器人辅助"一体位"腹腔镜根治性肾输尿管全长切除联合膀胱袖状切除术，即半尿路切除术中的安全性和有效性。

方法

回顾性分析2021年12月至2024年12月，中国医学科学院北京协和医院泌尿外科117例接受机器人辅助腹腔镜"一体位"半尿路切除术的UTUC患者临床资料。其中，52例采用康多机器人系统(K-RRNU组)，65例采用达芬奇机器人系统(D-RRNU组)。研究收集并比较了两组患者的人口统计学特征、临床资料、围手术期数据及随访结果。

结果

两组患者的基线人口学特征及术前临床资料无显著差异(P>0.05)。两组手术成功率均为100%，无患者中转开放或腹腔镜手术。在围手术期，K-RRNU组的手术时间和控制台操作时间显著长于D-RRNU组(P<0.05)，但两组的并发症发生率、术后住院时间及术后肿瘤学结局(RFS与CSS)方面未见显著差异(P>0.05)。K-RRNU组的住院费用显著低于D-RRNU组(P<0.05)。

结论

与达芬奇机器人系统相比，康多机器人手术系统在机器人辅助腹腔镜"一体位"半尿路切除术中的应用同样安全且有效。

关键词: 一体位, 肾输尿管切除术, 康多机器人, 达芬奇机器人, 并发症, 预后
Objective

To compare the safety and efficacy of the KangDuo surgical robotic system (KD-SR-01/KD-SR-02) and the da Vinci surgical robotic system (Si/Xi) in single-position robot-assisted laparoscopic radical nephroureterectomy.

Methods

A retrospective review was conducted of 117 patients with upper tract urothelial carcinoma (UTUC) who underwent single-position robot-assisted laparoscopic radical nephroureterectomy at the Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, between Dec. 2021 and Dec. 2024. Among them, 52 patients underwent surgery with the KangDuo robotic system (K-RRNU group), and 65 patients underwent surgery with the da Vinci robotic system (D-RRNU group). Demographic characteristics, clinical data, perioperative outcomes, and follow-up results were collected and compared between the two groups.

Results

There were no significant differences in baseline demographic characteristics or preoperative clinical data between the two groups (P>0.05). Both groups had a 100% surgical success rate, with no conversions to open or conventional laparoscopic surgery. In terms of perioperative outcomes, the K-RRNU group had significantly longer operative time and console time than the D-RRNU group (P<0.05). However, no significant differences were observed between the two groups in complication rates, postoperative length of hospital stay, or oncological outcomes, including recurrence-free survival (RFS) and cancer-specific survival (CSS) (P>0.05). The K-RRNU group had significantly lower hospitalization costs than the D-RRNU group (P<0.05).

Conclusion

Compared with the da Vinci robotic system, the KangDuo robotic system demonstrated comparable safety and efficacy in single-position robot-assisted laparoscopic radical nephroureterectomy.

Key words: Single-position surgery, Nephroureterectomy, KangDuo robot, da Vinci robot, Perioperative complications, Prognosis
图1 机器人辅助腹腔镜根治性肾输尿管切除术穿刺套管布局(左侧)
表1 K-RRNU组和D-RRNU组患者临床一般资料的比较
基线资料 K-RRNU组(n＝52) D-RRNU组(n＝65) P值
年龄(岁) 66.84±8.11 67.52±7.63 0.223
性别[例(%)]      
男 31(59.62) 37(56.92) 0.769
女 21(40.38) 28(43.08)  
体质量指数(kg/m2) 23.4 (20.8, 26.1) 23.6 (21.2, 25.8) 0.647
高血压[例(%)] 19 (36.54) 28 (43.08) 0.474
糖尿病[例(%)] 15 (28.85) 21 (32.31) 0.687
合并肾积水[例(%)] 28 (53.85) 30 (46.15) 0.741
肿瘤侧别[例(%)]      
左侧 25 (48.08) 36 (55.38) 0.432
右侧 27 (51.92) 29 (44.62)  
肿瘤部位[例(%)]      
肾盂 39 (75.00) 45 (69.23) 0.491
输尿管 13 (25.00) 20 (30.77)  
肿瘤分期[例(%)]      
T1/T2 33 (63.46) 39 (60.00) 0.702
T3/T4 19 (36.54) 26 (40.00)  
病理分级[例(%)]      
高级别 42 (80.75) 50 (76.92) 0.635
低级别 10 (19.25) 15 (23.08)  
淋巴结清扫[例(%)]      
是 10 (19.23) 15 (23.08) 0.614
否 42 (80.77) 50 (76.92)  
肿瘤最大径(cm) 4.28±1.31 3.95±1.12 0.426
表2 K-RRNU组和D-RRNU组患者的围手术期指标比较
围手术期指标 K-RRNU组(n＝52) D-RRNU组(n＝65) P值
手术时间(±s, min) 236.10±64.62 198.42±48.28 0.023
机器人对接时间(±s, min) 14.43±4.71 12.40±3.41 0.071
控制台操作时间(±s, min) 188.81±43.55 162.75±26.19 0.011
术中出血量(ml) 100 (50，150) 100 (50，200) 0.288
术中输血[例(%)] 3 2 0.474
术后输血[例(%)] 2 2 0.820
中转开腹[例(%)] 0 0  
手术切缘阳性[例(%)] 0 0  
围术期eGFR [例(%)]      
术前eGFR≥60 41 (78.85) 52 (80.00) 0.878
术后eGFR≥60 24 (46.15) 34 (52.31) 0.508
Clavien-Dindo分级的术后并发症[例(%)]      
Ⅰ/Ⅱ 11 (21.15) 19 (29.23) 0.320
Ⅲ/Ⅳ 2 (5.77) 1 (3.07)  
术后住院时间(d) 6 (4, 7) 5 (4, 6) 0.162
总体费用(万元) 3.29±1.11 6.54±1.46 < 0.001
术后辅助化疗[例(%)] 18 (34.62) 25 (38.46) 0.668
图2 两组上尿路尿路上皮癌患者的Kaplan-Meier生存曲线注：A.无复发生存(RFS) Kaplan-Meier生存曲线；B.肿瘤特异生存(CSS) Kaplan-Meier生存曲线
[1]
Masson-Lecomte A, Birtle A, Pradere, B, et al. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: Summary of the 2025 Update [J]. Eur Urol, 2025, 87(6): 697-716.
[2]
Takahashi K, Ikarashi D, Kitano S, et al. Immunological profile of the tumor immune microenvironment of upper tract urothelial carcinoma predicts recurrence patterns [J]. Cancer Immunol Immunother, 2026, 75(2): 41.
[3]
Li D, Ruan ZW, Lin F, et al. Transperitoneal versus retroperitoneal laparoscopic nephroureterectomy: a meta-analysis of technical approaches for upper tract urothelial carcinoma [J]. Langenbecks Arch Surg, 2025, 411(1): 18. DOI: 10.1007/s00423-025-03905-3.
[4]
Han XM, Zhou MH, Xiong M, et al. Single-position intraperitoneal laparoscopic radical nephroureterectomy using a modified supine position [J]. BMC Urol, 2025, 25(1): 296.
[5]
XingHN, Yang T, Liu P, et al. Modified three-arm port configuration for single-position, single-docking robotic nephroureterectomy: perioperative and oncological outcomes [J]. Translational andrology and urology, 2026, 15(1): 20.
[6]
黄曼维，杨镇泽，陈一博，等. 手术机器人赋能腔镜外科：技术进展与未来趋势[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18 (4): 251-256.
[7]
Rassweiler J, Autorino R, Klein J, et al. Future of robotic surgery in urology [J]. BJU international, 2017, 120(6): 822-841.
[8]
Zargar H, Krishnan J, Autorino R, et al. Robotic nephroureterectomy: a simplified approach requiring no patient repositioning or robot redocking. European urology, 2014, 66(4): 769-777.
[9]
De Groote R, Decaestecker K, Larcher A, et al. Robot-assisted nephroureterectomy for upper tract urothelial carcinoma: results from three high-volume robotic surgery institutions [J]. Journal of robotic surgery, 2020, 14(1): 211-219.
[10]
Lorusso G, Assumma S, Gavi F, et al. Urology in the digital age: The power of telemedicine [J]. Urologia, 2025, 92(4): 553-558.
[11]
Wen Z, Yang YX, Yu S, et al. KangDuo surgical robot versus da Vinci robotic system in urologic surgery: a systematic review and meta-analysis [J]. Journal of robotic surgery, 2024, 19(1): 6.
[12]
Pal A, Gamage R. Robotic abdominopelvic surgery: a systematic review of cross-platform outcomes [J]. Journal of robotic surgery, 2024, 18(1): 386.
[13]
Li XC, Huang XF, Cheng W, et al. An early experience of the robot-assisted laparoscopic nephroureterectomy without re-docking in a single position [J]. Annali italiani di chirurgia, 2020, 91: 327-333.
[14]
Zhang, S, Luo Y, Wang C, et al. Long-term oncologic outcomes of laparoscopic nephroureterectomy versus open nephroureterectomy for upper tract urothelial carcinoma: a systematic review and meta-analysis[J]. PeerJ, 2016, 4: e2063.
[15]
Rajan K, Khalifa A, Geraghty R, et al. Oncological Efficacy of Robotic Nephroureterectomy vs. Open and Laparoscopic Nephroureterectomy for Suspected Non-Metastatic UTUC-A Systematic Review and Meta-Analysis [J]. Cancers, 2023, 15(20): 4926.
[16]
Chang CL, Tsai CY, Cheng PY, et al. Robot-Assisted Radical Nephroureterectomy: A Safe and Effective Option for Upper Tract Urothelial Carcinoma, Especially for Novice Surgeons [J]. Cancers, 2025, 17(9): 1394.
[17]
Wen Z, Yang YX, Yu S, et al. KangDuo surgical robot versus da Vinci robotic system in urologic surgery: a systematic review and meta-analysis [J]. Journal of robotic surgery, 2024, 19(1): 6.
[18]
Cao S, Li HW, Qin J, et al. Comparative meta-analysis of perioperative outcomes following robot-assisted renal surgery: KangDuo versus Da Vinci systems [J]. Journal of robotic surgery, 2025. 20(1): 127.
[19]
D Ubak A, Karwacki J, Logoń K, et al. Lymph Node Dissection in Upper Tract Urothelial Carcinoma: Current Status and Future Perspectives [J]. Current oncology reports, 2023, 25(11): 1327-1344.
[20]
Lange S, Calleris G, Matin SF, et al. Optimizing Lymph Node Dissection at the Time of Nephroureterectomy for High-risk Upper Tract Urothelial Carcinoma [J]. European urology focus, 2023, 9(2): 280-282.
[21]
McIntosh AG, Umbreit EC, Wood CG, et al. Role of lymph node dissection at the time of open or minimally invasive nephroureterectomy [J]. Translational andrology and urology, 2021, 10(5): 2233-2245.
[22]
Reese A, Gonzalgo ML, Margulis V, et al. Outcomes of Lymph Node Dissection in Nephroureterectomy in the Treatment of Upper Tract Urothelial Carcinoma: Analysis of the ROBUUST Registry [J]. The Journal of urology, 2022, 208(2): 268-276.
[23]
Sighinolfi MC, Pallotta G, Rossi F, et al. Economic assessment of next-generation robotic surgical systems compared with the multiport da Vinci platform: a comprehensive review [J]. Journal of robotic surgery, 2026. 20(1): 206.
[24]
张恭，杨叶蓁，王斐，等. 腔镜手术机器人研发的关键问题及解决对策[J/OL]. 中华腔镜外科杂志(电子版), 2025, 18 (3): 129-133.
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