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机器人辅助妇科肿瘤学手术——来自英国三级转诊中心的项目启动和初步学习曲线:吉尔福德视角。

Robot assisted surgery in gynaecologic oncology - starting a program and initial learning curve from a UK tertiary referral centre: the Guildford perspective.

机构信息

Dept. of Gynaecological Oncology, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.

出版信息

Int J Med Robot. 2012 Dec;8(4):496-503. doi: 10.1002/rcs.1461. Epub 2012 Oct 22.

Abstract

BACKGROUND

The paper discusses the setup and evaluation of early data following the establishment of a robotic surgery programme in a UK gynaecological oncology cancer centre.

METHODS

Prospective data were collected between December 2009 and December 2011 for all women undergoing robotic assisted procedures within the gynaecological oncology department. Patient demographics, intra, peri and post-operative data were collected at a single institution, which is a tertiary referral centre for gynaecological oncology and minimal access surgery.

RESULTS

In total, 104 robotically assisted cases were performed within the gynaecological oncology team. The procedures undertaken included simple and radical hysterectomy, radical trachelectomy, BSO following previous hysterectomy, pelvic and para-aortic node dissection and omentectomy. The mean blood loss was 155.24 mL and the mean hospital stay was 3 days with more than half the women being discharged on day 1 post surgery.

CONCLUSIONS

These data suggest that robotic assisted surgery is well suited to treating women with principally endometrial and cervical cancers and selected cases of ovarian cancer, enabling surgical staging to be completed with many more patients benefitting from a minimal access surgery approach. Thorough preparation, appropriate case selection and preceptorship in robotic surgery is essential to minimize the associated risks associated with adopting new surgical techniques.

摘要

背景

本文讨论了在英国妇科肿瘤癌症中心建立机器人手术项目后,早期数据的设置和评估。

方法

在 2009 年 12 月至 2011 年 12 月期间,为妇科肿瘤科内接受机器人辅助手术的所有女性收集了前瞻性数据。在一家机构收集了患者人口统计学数据、术中、围手术期和术后数据,该机构是妇科肿瘤学和微创手术的三级转诊中心。

结果

妇科肿瘤团队共完成了 104 例机器人辅助手术。开展的手术包括简单和根治性子宫切除术、根治性宫颈切除术、既往子宫切除术后的 BSO、盆腔和主动脉旁淋巴结清扫术和网膜切除术。平均失血量为 155.24ml,平均住院时间为 3 天,超过一半的女性在术后第 1 天出院。

结论

这些数据表明,机器人辅助手术非常适合治疗主要患有子宫内膜癌和宫颈癌以及部分卵巢癌的女性,可以完成手术分期,使更多的患者受益于微创手术方法。彻底的准备、适当的病例选择和机器人手术的指导对于最小化采用新手术技术相关的风险至关重要。

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