Magrina Javier F, Kho Rosanne M, Weaver Amy L, Montero Regina P, Magtibay Paul M
Division of Obstetrics and Gynecology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA.
Gynecol Oncol. 2008 Apr;109(1):86-91. doi: 10.1016/j.ygyno.2008.01.011. Epub 2008 Feb 14.
Comparison of perioperative results of patients undergoing radical hysterectomy by robotics, laparoscopy, and laparotomy.
Prospective analysis of 27 patients undergoing robotic radical hysterectomy between April 2003 and September 2006. Comparison was made with patients operated by laparoscopy and laparotomy matched by age, BMI, site and type of malignancy, FIGO staging, and type of radical hysterectomy.
The mean operating times for patients undergoing robotic, laparoscopy and laparotomy radical hysterectomy were 189.6, 220.4, and 166.8 min, respectively; the mean blood loss was 133.1, 208.4, and 443.6 ml, respectively; the mean rate of blood loss was 0.7, 0.9, and 2.6 ml/min, respectively; the mean number of removed lymph nodes was 25.9, 25.9, and 27.7, respectively; and the mean length of hospital stay was 1.7, 2.4, and 3.6 days, respectively. There were no significant differences in intra- or postoperative complications among the three groups, no fistula formation in any patient and no conversions in the robotic or laparoscopic groups. At a mean follow up of 31.1 months, none of the patients with cervical cancer has experienced recurrence.
Laparoscopy and robotics are preferable to laparotomy for patients requiring radical hysterectomy. Operating times for robotics and laparotomy were similar, and significantly shorter as compared to laparoscopy. Blood loss, rate of blood loss and length of hospital stay were similar for laparoscopy and robotics and significantly reduced as compared to laparotomy.
比较接受机器人辅助根治性子宫切除术、腹腔镜根治性子宫切除术和开腹根治性子宫切除术患者的围手术期结果。
对2003年4月至2006年9月期间接受机器人辅助根治性子宫切除术的27例患者进行前瞻性分析。与年龄、体重指数、恶性肿瘤部位和类型、国际妇产科联盟（FIGO）分期以及根治性子宫切除术类型相匹配的接受腹腔镜手术和开腹手术的患者进行比较。
接受机器人辅助、腹腔镜和开腹根治性子宫切除术患者的平均手术时间分别为189.6分钟、220.4分钟和166.8分钟；平均失血量分别为133.1毫升、208.4毫升和443.6毫升；平均失血率分别为0.7毫升/分钟、0.9毫升/分钟和2.6毫升/分钟；平均切除淋巴结数分别为25.9个、25.9个和27.7个；平均住院时间分别为1.7天、2.4天和3.6天。三组患者术中或术后并发症无显著差异，所有患者均未形成瘘管，机器人辅助组或腹腔镜组均无中转开腹情况。平均随访31.1个月，所有宫颈癌患者均未复发。
对于需要进行根治性子宫切除术的患者，腹腔镜手术和机器人辅助手术优于开腹手术。机器人辅助手术和开腹手术的手术时间相似，且与腹腔镜手术相比明显更短。腹腔镜手术和机器人辅助手术的失血量、失血率和住院时间相似，且与开腹手术相比显著减少。
