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机器人辅助手术用于子宫内膜癌分期后切口部位转移的低发生率:描述性分析

Low incidence of port-site metastasis after robotic assisted surgery for endometrial cancer staging: descriptive analysis.

作者信息

Barraez D, Godoy H, McElrath T, Kredentser D, Timmins P

机构信息

Berkshire OB/GYN Associates PC, Pittsfield, MA, USA.

Women's Cancer Care Associates, Albany, NY, USA.

出版信息

J Robot Surg. 2015 Mar;9(1):91-5. doi: 10.1007/s11701-014-0491-y. Epub 2014 Nov 5.

Abstract

The purpose of this study was to evaluate the incidence and characteristics of patients with port-site metastasis following robotic assisted surgery for gynecological malignancies. Patients who underwent robotic assisted total laparoscopic hysterectomy and surgical staging at a single institution from November 2006 through November 2011 were retrospectively identified. Medical records were reviewed and the following information was extracted: diagnosis, histology, tumor extension, procedure, complications and post-surgical intervention. Port-site metastases were differentiated between isolated and not isolated. All metastases were confirmed with biopsy and treated with chemotherapy and radiotherapy as indicated. Four hundred forty-six patients with endometrial carcinoma were identified who had undergone robotic assisted hysterectomy and staging. Eight patients were converted to laparotomy and excluded from the study. Of 438 patients, 384 patients were diagnosed with early stages (stages 1 and 2), and 54 were diagnosed with advanced stages (stages 3 and 4). A total of 332 patients underwent pelvic lymphadenectomy regardless of the endometrial cancer stage; of those, 283 with early stage disease underwent pelvic lymphadenectomy, while 49 with advanced stage disease underwent pelvic lymphadenectomy. One hundred seventy-six patients received adjuvant treatment after surgical staging. Four patients were identified with port-site metastases (0.9 %), two patients were reported as isolated metastases. The mean patient age was 63 and mean BMI was 37 kg/m(2). The incidence of port-site metastasis is low after robotic assisted surgery for treatment of endometrial cancer (0.9 %). There is no clear risk factor for development of port-site metastasis or easily identifiable prevention.

摘要

本研究的目的是评估妇科恶性肿瘤机器人辅助手术后切口转移患者的发生率及特征。回顾性确定了2006年11月至2011年11月在单一机构接受机器人辅助全腹腔镜子宫切除术及手术分期的患者。查阅病历并提取以下信息:诊断、组织学、肿瘤扩展情况、手术过程、并发症及术后干预措施。将切口转移分为孤立性和非孤立性。所有转移均经活检证实,并根据情况进行化疗和放疗。确定了446例行机器人辅助子宫切除术及分期的子宫内膜癌患者。8例转为开腹手术,被排除在研究之外。438例患者中,384例诊断为早期(1期和2期),54例诊断为晚期(3期和4期)。无论子宫内膜癌分期如何,共有332例患者接受了盆腔淋巴结切除术;其中,283例早期疾病患者接受了盆腔淋巴结切除术,49例晚期疾病患者接受了盆腔淋巴结切除术。176例患者在手术分期后接受了辅助治疗。4例患者被确定有切口转移(0.9%),2例报告为孤立性转移。患者平均年龄为63岁,平均体重指数为37kg/m²。机器人辅助手术治疗子宫内膜癌后切口转移的发生率较低(0.9%)。切口转移的发生没有明确的危险因素,也没有易于识别的预防方法。

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