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比较机器人手术与传统腹腔镜手术及剖腹手术在宫颈癌治疗中的应用。

Comparing robotic surgery with conventional laparoscopy and laparotomy for cervical cancer management.

作者信息

Chen Ching-Hui, Chiu Li-Hsuan, Chang Ching-Wen, Yen Yuan-Kuei, Huang Yan-Hua, Liu Wei-Min

机构信息

*Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; †Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; and ‡Graduate School of Human Sexuality, Shu-Te University, Kaohsiung County, Taiwan.

出版信息

Int J Gynecol Cancer. 2014 Jul;24(6):1105-11. doi: 10.1097/IGC.0000000000000160.

Abstract

OBJECTIVE

The aim of this study was to compare the outcomes of robotic surgery, laparoscopy, and laparotomy for the surgical treatment of stage IA to IIB cervical cancer.

METHODS

This retrospective study was carried out in a university-affiliated teaching hospital. A total of 100 women with an initial diagnosis of stage IA to IIB cervical cancer, without preoperative brachytherapy or chemotherapy, were included in this study. With selection of the cases, 44 patients received laparotomy surgery, 32 patients received laparoscopic surgery, and 24 patients received robotic surgery. The perioperative parameters measured included operation time, blood loss, transfusion rate, lymph node yield, adhesion score, laparotomy conversion rate, postoperative and 24-hour pain scores, time to full diet resumption, and hospital stay. The perioperative complication and disease-free survival were also evaluated.

RESULTS

The robotic group showed a shorter operation time, less blood loss, lower transfusion rate, and lower laparotomy conversion rate than the laparoscopic or laparotomy group. As for the postoperative parameters, the robotic group showed reduced postoperative and 24-hour pain scores, shortened length of hospital stay, and decreased time to full diet resumption compared with the other 2 surgical groups. No significant differences were found between the groups in perioperative complication rate or disease-free survival.

CONCLUSIONS

The data suggested that robotic surgery is a feasible and potentially optimal option for the treatment of stage IA to IIB cervical cancer with favorable short-term surgical outcomes.

摘要

目的

本研究旨在比较机器人手术、腹腔镜手术和开腹手术治疗IA至IIB期宫颈癌的效果。

方法

本回顾性研究在一所大学附属医院开展。共有100例初诊为IA至IIB期宫颈癌且未接受术前近距离放疗或化疗的女性纳入本研究。经病例筛选,44例患者接受开腹手术,32例患者接受腹腔镜手术,24例患者接受机器人手术。测量的围手术期参数包括手术时间、失血量、输血率、淋巴结获取数量、粘连评分、开腹手术转换率、术后及术后24小时疼痛评分、恢复正常饮食时间和住院时间。还评估了围手术期并发症和无病生存率。

结果

与腹腔镜手术组或开腹手术组相比,机器人手术组手术时间更短、失血量更少、输血率更低且开腹手术转换率更低。至于术后参数,与其他两组手术相比,机器人手术组术后及术后24小时疼痛评分降低、住院时间缩短且恢复正常饮食时间减少。各组围手术期并发症发生率或无病生存率无显著差异。

结论

数据表明,机器人手术是治疗IA至IIB期宫颈癌的一种可行且可能最佳的选择,具有良好的短期手术效果。

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