Paoli Calmettes Institute, Department of Surgery, 232 bd Sainte Marguerite, BP 156, 13009 Marseille, France.
Eur J Surg Oncol. 2010 Apr;36(4):409-13. doi: 10.1016/j.ejso.2009.12.004. Epub 2010 Jan 15.
The aim of this study was to compare the feasibility and efficacy of robot-assisted laparoscopy with traditional laparotomy and conventional laparoscopy in a series of patients with locally advanced cervical cancer managed in our two institutions.
Twenty-two patients who underwent robot-assisted laparoscopy were compared with 20 patients who underwent adjuvant surgery by laparotomy and 16 who underwent conventional laparoscopy, before the arrival of the Da Vinci surgical system.
There was no significant difference between the three groups in terms of body mass index, FIGO stage, or tumor histology. The complication rate was similar in the three groups of patients, although there was a trend towards more lymphatic complications in the robot-assisted subgroup managed medically. There was no significant difference in the recurrence rate between the robot-assisted laparoscopy, conventional laparoscopy and laparotomy groups (27.3%, 29.4% and 30%, respectively).
Robot-assisted laparoscopy is feasible after concurrent chemoradiation and brachytherapy in cases of locally advanced cervical cancer. This new surgical approach reduces hospital stay, and seems to result in less severe complications than conventional laparotomy without modifying the oncological outcome.
本研究旨在比较机器人辅助腹腔镜手术与传统开腹手术和常规腹腔镜手术在我们两家机构治疗局部晚期宫颈癌患者系列中的可行性和疗效。
在达芬奇手术系统到来之前，我们比较了 22 例接受机器人辅助腹腔镜手术的患者、20 例接受辅助性开腹手术的患者和 16 例接受常规腹腔镜手术的患者。
三组患者的体重指数、FIGO 分期或肿瘤组织学均无显著差异。三组患者的并发症发生率相似，但机器人辅助组中经医学治疗的患者存在更多的淋巴并发症趋势。机器人辅助腹腔镜组、常规腹腔镜组和开腹组的复发率无显著差异（分别为 27.3%、29.4%和 30%）。
局部晚期宫颈癌同步放化疗和近距离放疗后行机器人辅助腹腔镜手术是可行的。这种新的手术方法可减少住院时间，且似乎比传统开腹手术导致的严重并发症更少，而不会改变肿瘤学结果。
