子宫内膜癌分期子宫切除术的三种手术方法比较研究：机器人辅助手术、腹腔镜手术、开腹手术。
A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy.
作者信息
Boggess John F, Gehrig Paola A, Cantrell Leigh, Shafer Aaron, Ridgway Mildred, Skinner Elizabeth N, Fowler Wesley C
机构信息
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA.
出版信息
Am J Obstet Gynecol. 2008 Oct;199(4):360.e1-9. doi: 10.1016/j.ajog.2008.08.012.
OBJECTIVE
The purpose of this study was to compare outcomes in women who underwent endometrial cancer staging by different surgical techniques.
STUDY DESIGN
Three hundred twenty-two women underwent endometrial cancer staging: 138 by laparotomy (TAH); 81 by laparoscopy (TLH) and 103 by robotic technique (TRH).
RESULTS
The TRH cohort had a higher body mass index than the TLH cohort (P = .0008). Lymph node yield was highest for TRH (P < .0001); hospital stay (P < .0001) and estimated blood loss (P < .0001) were lowest for this cohort. Operative time was longest for TLH (213.4 minutes) followed by TRH (191.2 minutes) and TAH (146.5 minutes; P < .0001. Postoperative complication rates were lower for TRH, compared with TAH (5.9% vs 29.7%; P < .0001). Conversion rates for the robotic and laparoscopic groups were similar.
CONCLUSION
TRH with staging is feasible and preferable over TAH and may be preferable over TLH in women with endometrial cancer. Further study is necessary to determine long-term oncologic outcomes.
目的
本研究旨在比较采用不同手术技术进行子宫内膜癌分期的女性患者的治疗结果。
研究设计
322例女性接受了子宫内膜癌分期手术：138例行剖腹手术（TAH）；81例行腹腔镜手术（TLH）；103例行机器人手术（TRH）。
结果
TRH组患者的体重指数高于TLH组（P = .0008）。TRH组的淋巴结切除数量最多（P < .0001）；该组患者的住院时间（P < .0001）和估计失血量（P < .0001）最少。TLH组的手术时间最长（213.4分钟），其次是TRH组（191.2分钟）和TAH组（146.5分钟；P < .0001）。与TAH组相比，TRH组的术后并发症发生率较低（5.9% 对29.7%；P < .0001）。机器人手术组和腹腔镜手术组的中转开腹率相似。
结论
对于子宫内膜癌女性患者，TRH分期手术是可行的，优于TAH，可能也优于TLH。有必要进行进一步研究以确定长期肿瘤学结局。
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