Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy.
Eur J Surg Oncol. 2015 Jan;41(1):136-41. doi: 10.1016/j.ejso.2014.10.048. Epub 2014 Oct 28.
The aim of this study was to verify possible differences in terms of perioperative outcomes and complications between mini-laparoscopic radical hysterectomy with lymphadenectomy (mLRH) and robotic radical hysterectomy with lymphadenectomy (RRH) in patients with early cervical cancer (ECC).
In this retrospective study, thirty women with early stage cervical cancer who underwent mini-laparoscopic radical hysterectomy plus lymphadenectomy (mLRH) were compared with a cohort of thirty women who underwent robotic multiport radical hysterectomy (RRH). The study involved patients, between August 2010 and December 2012, from three Italian institutions: National Cancer Institute of Rome, University of Insubria, Varese, and the Catholic University of the Sacred Heart of Rome.
No significant differences between groups were observed in terms of age, BMI, previous abdominal surgery or FIGO stage. Operative time, blood loss, need of blood transfusion, risk of intra- and post-operative complications, and lymph nodes yield were similar between mLRH and RRH in patients with ECC. The median length of hospital stay was 2 days in the mLRH group and 3 days in the RRH group (p < 0.05).
The few differences we registered do not seem clinically relevant, thus making the two procedures comparable. The decision on how to gain best access for radical hysterectomy considers the surgeon's skill and experience with the different possible approaches. Further randomized trials are needed to determine whether mini-laparoscopic techniques truly offer any advantages.
本研究旨在验证早期宫颈癌患者行迷你腹腔镜根治性子宫切除术加淋巴结切除术(mLRH)与机器人根治性子宫切除术加淋巴结切除术(RRH)在围手术期结局和并发症方面的差异。
本回顾性研究比较了 2010 年 8 月至 2012 年 12 月间来自意大利三个机构的 30 例接受迷你腹腔镜根治性子宫切除术加淋巴结切除术(mLRH)的早期宫颈癌患者与 30 例接受机器人多端口根治性子宫切除术(RRH)的患者。
两组患者的年龄、BMI、既往腹部手术史或 FIGO 分期无显著差异。ECC 患者的手术时间、出血量、输血需求、术中及术后并发症风险和淋巴结检出数在 mLRH 和 RRH 之间相似。mLRH 组的中位住院时间为 2 天,RRH 组为 3 天(p<0.05)。
我们记录的差异似乎没有临床意义,因此两种手术方法具有可比性。选择何种方法获得根治性子宫切除术的最佳途径需要考虑外科医生的技能和对不同可能方法的经验。需要进一步的随机试验来确定迷你腹腔镜技术是否真的具有优势。