Boggess John F, Gehrig Paola A, Cantrell Leigh, Shafer Aaron, Mendivil Alberto, Rossi Emma, Hanna Rabbie
From the Department of Obstetrics and Gynecology, Division of Gynecology Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Obstet Gynecol. 2009 Sep;114(3):585-593. doi: 10.1097/AOG.0b013e3181b47030.
To report on the perioperative outcomes after robotically assisted total hysterectomy for benign indications in a large patient population with predominantly complex pathology.
One hundred fifty-two patients underwent robotic hysterectomy for noncancer indications from May 2005 to May 2008. A systematic chart review of consecutive robotic cases was conducted based on preoperative and perioperative characteristics of each patient. Each case was evaluated for its complexity based on preoperative diagnosis, prior pelvic or abdominal surgery, patient's body mass index, and uterine weight.
The overall operative time was 122.9 minutes, estimated blood loss was 79.0 mL, and there were three (2.1%) intraoperative complications, with no perioperative blood transfusions or conversions. There were five (3.5%) patients with postoperative complications, and length of hospital stay was 1.0 days on average. Of the characteristics indicating complexity, only uterine weight greater than 250 g resulted in significantly increased operative times, attributable to increased morcellation time.
Robotically assisted total hysterectomy for benign indications in patients with complex pathology is feasible, with low morbidity and a short hospital stay. This study suggests that robotic assistance facilitates the use of a minimally invasive approach in high-risk patient populations.
III.
报告在大量主要患有复杂病症的患者群体中，机器人辅助下全子宫切除术治疗良性疾病的围手术期结果。
2005年5月至2008年5月期间，152例患者因非癌症适应症接受了机器人子宫切除术。根据每位患者的术前和围手术期特征，对连续的机器人手术病例进行系统的图表回顾。根据术前诊断、既往盆腔或腹部手术、患者体重指数和子宫重量对每个病例的复杂性进行评估。
总体手术时间为122.9分钟，估计失血量为79.0毫升，术中并发症有3例（2.1%），无围手术期输血或中转开腹情况。术后并发症患者有5例（3.5%），平均住院时间为1.0天。在表明复杂性的特征中，只有子宫重量大于250克导致手术时间显著延长，这归因于粉碎时间增加。
对于患有复杂病症的患者，机器人辅助下全子宫切除术治疗良性疾病是可行的，发病率低且住院时间短。本研究表明，机器人辅助有助于在高危患者群体中采用微创方法。
III级。
