Finger Tamara Natasha, Nezhat Farr Reza
St Luke's-Roosevelt Hospital Center, New York, NY, USA.
St Luke's-Roosevelt Hospital Center, 425 W 59th St, Suite 9B, New York, NY, 10019, USA..
JSLS. 2014 Apr-Jun;18(2):308-13. doi: 10.4293/108680813X13654754535557.
To show the feasibility and safety of robotic-assisted laparoscopic fertility-sparing surgery for earlystage ovarian cancer in women of reproductive age.
The first patient was a 29-year-old para 0 woman with well-differentiated endometrioid adenocarcinoma of the ovary and complex endometrial hyperplasia with marked atypia. The second patient was a 31-year-old para 0 woman with an immature grade 1 teratoma. Both patients underwent robotic-assisted laparoscopic surgical staging.
In the first patient, there were no intra- or postoperative complications. Operative time was 5 hours 43 minutes and estimated blood loss was 100 mL. She was discharged home on postoperative day 1. She received 3 cycles of carboplatin and paclitaxel, as well as medroxyprogesterone acetate for the duration of chemotherapy. She conceived twice spontaneously since surgery and had two successful deliveries. She currently has no evidence of disease. In the second patient, there were no intra- or postoperative complications. Operative time was 2 hours 52 minutes and estimated blood loss was 200 mL. She was discharged home on postoperative day 1. She declined adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. She conceived spontaneously 4 months later and had a normal vaginal delivery. She currently has no evidence of disease.
Because fertility-sparing surgery is now accepted as a viable option in young women with earlystage ovarian cancer, less invasive techniques are being used. With the advent of robotic-assisted surgery and its advantages over conventional laparoscopy, we show that it is a safe and feasible approach in select patients. This is the first reported series on robotic fertility-sparing surgery, but more research is needed.
探讨机器人辅助腹腔镜保留生育功能手术治疗育龄期早期卵巢癌的可行性及安全性。
首例患者为一名29岁未育女性，患有高分化卵巢子宫内膜样腺癌及伴有明显异型性的复杂性子宫内膜增生。第二例患者是一名31岁未育女性，患有1级未成熟畸胎瘤。两名患者均接受了机器人辅助腹腔镜手术分期。
首例患者术中及术后均无并发症。手术时间为5小时43分钟，估计失血量为100毫升。她于术后第1天出院。她在化疗期间接受了3个周期的卡铂和紫杉醇治疗，以及醋酸甲羟孕酮治疗。自手术以来，她自然受孕两次并成功分娩两次。目前她没有疾病证据。第二例患者术中及术后均无并发症。手术时间为2小时52分钟，估计失血量为200毫升。她于术后第1天出院。她拒绝了博来霉素、依托泊苷和顺铂的辅助化疗。4个月后她自然受孕并顺产。目前她没有疾病证据。
由于保留生育功能手术现已被认为是早期卵巢癌年轻女性的可行选择，因此正在采用侵入性较小的技术。随着机器人辅助手术的出现及其相对于传统腹腔镜手术的优势，我们表明在特定患者中这是一种安全可行的方法。这是首次报道的关于机器人保留生育功能手术的系列研究，但仍需要更多研究。
