机器人辅助经腹腔主动脉淋巴结切除术在妇科恶性肿瘤中的应用：一种新的机器人手术技术及文献复习。

Robotic transperitoneal aortic lymphadenectomy in gynecologic cancer: a new robotic surgical technique and review of the literature.

机构信息

Gynecologic Oncologic Unit, National Cancer Institute Regina Elena, Rome, Italy.

出版信息

Ann Surg Oncol. 2012 Nov;19(12):3832-8. doi: 10.1245/s10434-012-2411-6. Epub 2012 May 30.

DOI:10.1245/s10434-012-2411-6

PMID:22644509

Abstract

BACKGROUND

Lymph node status is a prognostic factor for gynecologic cancer. We describe a new developing strategy for robotic transperitoneal aortic lymphadenectomy without relocating the robotic column or the patient.

METHODS

Patients with histologically confirmed cervical cancer, early ovarian cancer, or endometrial carcinoma with suspected risk factors indicating aortic lymphadenectomy were eligible for the robotic transperitoneal aortic lymphadenectomy using the Da Vinci robotic system as part of the surgical treatment of gynecologic malignancies.

RESULTS

The mean operating time was 224 min (range 160-300 min), and the mean console time for aortic lymphadenectomy was 43 min (range 30-75). The median hemoglobin fall was 1.3 g/dL range (0.8-2 g/dL), the median number of removed aortic lymph nodes was 12.5 (range 7-17), and the median length of the hospital stay was 2 days (range 1-4 days). We experienced an intraoperative complication, but no conversion to laparotomy was necessary. No patients received a blood transfusion.

CONCLUSIONS

This initial experience demonstrates the feasibility of robotic aortic lymphadenectomy with good accuracy and safety without relocating the robotic column or the patient.

摘要

背景

淋巴结状态是妇科癌症的预后因素。我们描述了一种新的发展策略，用于机器人经腹主动脉淋巴结切除术，无需重新定位机器人柱或患者。

方法

经组织学证实患有宫颈癌、早期卵巢癌或子宫内膜癌且有主动脉淋巴结切除术指征的患者，符合接受机器人经腹主动脉淋巴结切除术的条件，该手术是妇科恶性肿瘤治疗的一部分，使用达芬奇机器人系统进行。

结果

平均手术时间为 224 分钟（范围 160-300 分钟），主动脉淋巴结切除术的平均控制台时间为 43 分钟（范围 30-75 分钟）。中位血红蛋白下降 1.3g/dL（范围 0.8-2g/dL），中位切除的主动脉淋巴结数为 12.5（范围 7-17），中位住院时间为 2 天（范围 1-4 天）。我们经历了一次术中并发症，但无需转为剖腹手术。没有患者需要输血。