Mendivil Alberto A, Rettenmaier Mark A, Abaid Lisa N, Brown John V, Micha John P, Lopez Katrina L, Goldstein Bram H
Gynecologic Oncology Associates, Newport Beach, CA USA.
Women's Cancer Research Foundation, Newport Beach, CA, USA.
JSLS. 2015 Jan-Mar;19(1):e2014.00001. doi: 10.4293/JSLS.2014.00001.
The intent of this retrospective study was to assess the operative outcomes of morbidly obese endometrial cancer patients who were treated with either open surgery (OS) or a minimally invasive procedure.
Morbidly obese (body mass index [BMI] > 40 kg/m(2)) patients with endometrial cancer who underwent OS, robotic-assisted laparoscopic surgery (RS), or conventional laparoscopic surgery (LS) were eligible. We sought to discern any outcome differences with regard to operative time, perioperative complications, and hospital stay.
Sixteen patients were treated with LS (BMI = 47.9 kg/m(2)), 13 were managed via RS (BMI = 51.2 kg/m(2)), and 24 underwent OS (BMI = 53.7 kg/m(2)). The OS (1.35 hours) patients had a significantly shorter operative duration than the LS (1.82 hours) and RS (2.78 hours) patients (P < .001); blood loss was greater in the OS (250 mL) group in comparison with the RS (100 mL) and LS (175 mL) patients (P = .002). Moreover, the OS (4 days) subjects had a significantly longer hospital stay than the LS (2 days) and RS (2 days) patients (P = .002).
In the present study, we ascertained that minimally invasive surgery was associated with longer operative times but lower rates of blood loss and shorter hospital stay duration compared with treatment comprising an open procedure.
本回顾性研究旨在评估接受开放手术(OS)或微创手术治疗的病态肥胖子宫内膜癌患者的手术结局。
符合条件的病态肥胖(体重指数[BMI]>40kg/m²)子宫内膜癌患者,接受了开放手术、机器人辅助腹腔镜手术(RS)或传统腹腔镜手术(LS)。我们试图找出手术时间、围手术期并发症和住院时间方面的任何结局差异。
16例患者接受了传统腹腔镜手术(BMI = 47.9kg/m²),13例接受了机器人辅助腹腔镜手术(BMI = 51.2kg/m²),24例接受了开放手术(BMI = 53.7kg/m²)。接受开放手术的患者(1.35小时)手术持续时间明显短于接受传统腹腔镜手术(1.82小时)和机器人辅助腹腔镜手术(2.78小时)的患者(P<0.001);与接受机器人辅助腹腔镜手术(100mL)和传统腹腔镜手术(175mL)的患者相比,开放手术组(250mL)的失血量更大(P = 0.002)。此外,接受开放手术的患者(4天)住院时间明显长于接受传统腹腔镜手术(2天)和机器人辅助腹腔镜手术(2天)的患者(P = 0.002)。
在本研究中,我们确定与开放手术治疗相比,微创手术的手术时间更长,但失血量更低,住院时间更短。