Corrado G, Cutillo G, Pomati G, Mancini E, Sperduti I, Patrizi L, Saltari M, Vincenzoni C, Baiocco E, Vizza E
Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
Eur J Surg Oncol. 2015 Aug;41(8):1074-81. doi: 10.1016/j.ejso.2015.04.020. Epub 2015 May 9.
To compare different techniques of minimally invasive surgery (laparoscopy and robotics) to abdominal surgery in order to identify the optimal surgical technique in the treatment of endometrial cancer.
A single-institutional, matched, retrospective, cohort study was performed. All patients with clinical stage I or occult stage II endometrial cancer who underwent robotic hysterectomy, bilateral salpingo-oophorectomy ± lymphadenectomy from August 2010 and December 2013 were identified. Surgical and oncological outcomes were compared with patients matched by age, body mass index, tumor histology, and grade, who underwent abdominal or laparoscopic surgery between January 2001 and December 2013.
Three groups were identified: 177 laparotomies (group A), 277 laparoscopies (group B) and 72 robotics (group C). There were no statistically significant differences between the three groups in terms of age, BMI and FIGO stage. The operative time was shortest in group B (p = 0.0001). Blood loss and transfusions were equivalent in group B and C, while they were greater in group A (p = 0.0001). The intra-operative, early and late postoperative complications, rate of conversion, the re-intervention and median hospital stay were lower in group C. The rate of recurrence and death from disease was similar in all three groups.
Minimally invasive surgery was superior to abdominal surgery in terms of surgical outcomes. Robotic surgery was superior to laparoscopy in terms of intra- and post-operative complications, conversion rates, length of hospital stay and re-interventions. In terms of oncological outcomes the three groups were equivalent.
比较微创手术（腹腔镜手术和机器人手术）与开腹手术治疗子宫内膜癌的不同技术，以确定治疗子宫内膜癌的最佳手术技术。
进行了一项单机构、匹配、回顾性队列研究。确定了2010年8月至2013年12月期间接受机器人子宫切除术、双侧输卵管卵巢切除术±淋巴结清扫术的所有临床I期或隐匿性II期子宫内膜癌患者。将手术和肿瘤学结果与2001年1月至2013年12月期间接受开腹或腹腔镜手术、年龄、体重指数、肿瘤组织学和分级相匹配的患者进行比较。
分为三组：177例开腹手术（A组）、277例腹腔镜手术（B组）和72例机器人手术（C组）。三组在年龄、BMI和国际妇产科联盟（FIGO）分期方面无统计学显著差异。B组手术时间最短（p = 0.0001）。B组和C组的失血量和输血情况相当，而A组更高（p = 0.0001）。C组的术中、术后早期和晚期并发症、中转率、再次干预率和中位住院时间较低。三组的疾病复发率和死亡率相似。
在手术结果方面，微创手术优于开腹手术。在术中及术后并发症、中转率、住院时间和再次干预方面，机器人手术优于腹腔镜手术。在肿瘤学结果方面，三组相当。
