Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, Korea.
J Surg Oncol. 2010 Feb 1;101(2):116-21. doi: 10.1002/jso.21436.
To demonstrate the feasibility of robot-assisted staging surgery using three arms in patients with endometrial cancer.
One hundred nine patients with clinical stage I endometrial cancer who underwent staging surgery at Yonsei University Health System were enrolled from May 2006 to January 2009. Patient demographics and operative outcomes were prospectively collected.
Robotic surgery using three arms was performed in 28 patients, laparoscopy in 25, and laparotomy in 56. There were no differences among the three groups in terms of patient demographics. The number of harvested pelvic lymph nodes was lower in the laparoscopy group than in the laparotomy group (18.36 +/- 7.25 vs. 24.39 +/- 10.08, respectively, P = 0.025), but there was no difference between the robot and laparotomy groups. The number of resected para-aortic lymph nodes and operative time did not differ among the three groups. The average hospital stay was longer for the laparotomy group than the robot and laparoscopy groups (10.78 days vs. 7.92 days vs. 7.67 days, respectively, P < 0.001). Operative complications and transfusions developed more frequently in the laparotomy group than in the robot and laparoscopy groups (25.0% vs. 7.1% vs. 8.0%, respectively, P = 0.049; 42.9% vs. 14.3% vs. 16.0%, respectively, P = 0.006).
Robot-assisted surgery using three arms is a feasible method for surgical staging in patients with clinical stage I endometrial cancer.
展示在临床Ⅰ期子宫内膜癌患者中使用三臂机器人辅助分期手术的可行性。
2006 年 5 月至 2009 年 1 月，在延世大学健康系统入组了 109 例临床Ⅰ期子宫内膜癌患者，行分期手术。前瞻性收集患者的人口统计学和手术结果。
28 例患者采用三臂机器人手术，25 例采用腹腔镜手术，56 例采用剖腹手术。三组患者的人口统计学特征无差异。腹腔镜组的盆腔淋巴结清扫数目低于剖腹组（18.36±7.25 对 24.39±10.08，P=0.025），但与机器人组无差异。三组的腹主动脉旁淋巴结切除数目和手术时间无差异。剖腹组的平均住院时间长于机器人组和腹腔镜组（10.78 天对 7.92 天对 7.67 天，P<0.001）。剖腹组的手术并发症和输血发生率高于机器人组和腹腔镜组（25.0%对 7.1%对 8.0%，P=0.049；42.9%对 14.3%对 16.0%，P=0.006）。
在临床Ⅰ期子宫内膜癌患者中，使用三臂机器人辅助手术是一种可行的手术分期方法。
