Corrado G, Mereu L, Bogliolo S, Cela V, Freschi L, Carlin R, Gardella B, Mancini E, Tateo S, Spinillo A, Vizza E
Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
Obstetrics and Gynecological Department, Santa Chiara Hospital, Trento, Italy.
Eur J Surg Oncol. 2016 Oct;42(10):1506-11. doi: 10.1016/j.ejso.2016.08.014. Epub 2016 Aug 30.
To evaluate the feasibility and the safety of robotic single site hysterectomy (RSSH) plus or less pelvic lymphadenectomy in FIGO stage I-II endometrial cancer.
We prospectively collected patient demographics, operative times, complications, pathologic results, and length of stay on all patients who underwent RSSH plus or less pelvic lymphadenectomy for clinical FIGO stage I or occult stage II endometrial carcinoma.
From January 2012 to February 2015, 125 patients were included in our study. The median age of the patients was 59 years (range, 35-84 years) and the median body mass index was 27 kg/m(2) (range, 19-52 kg/m(2)). One patient was converted to vaginal surgery due to problems of hypercapnia. The median docking time, console time, and total operative time was 11 min (range, 4-40 min), 80 min (range, 20-240 min) and 122 min (range, 35-282 min), respectively. The median blood loss was 50 ml (range, 10-250 ml). No laparoscopic/laparotomic conversion was registered. Twenty one patients underwent pelvic lymphadenectomy (16.8%) and the median pelvic lymph nodes was 13 (range, 3-32). The median time to discharge was 2 days (range, 1-3 days). No intra-operative complications occurred, while we observed 10 (8%) early post-operative complications.
RSSH plus or less pelvic lymphadenectomy is technically feasible, safe and reproducible and could be the treatment of choice for patients affected by FIGO stage I-II endometrial cancer. However, randomized controlled trials are needed to confirm these results.
评估机器人单孔子宫切除术(RSSH)联合或不联合盆腔淋巴结清扫术治疗国际妇产科联盟(FIGO)I-II期子宫内膜癌的可行性和安全性。
我们前瞻性收集了所有接受RSSH联合或不联合盆腔淋巴结清扫术治疗临床FIGO I期或隐匿性II期子宫内膜癌患者的人口统计学资料、手术时间、并发症、病理结果及住院时间。
2012年1月至2015年2月,125例患者纳入本研究。患者中位年龄为59岁(范围35-84岁),中位体重指数为27kg/m²(范围19-52kg/m²)。1例患者因高碳酸血症问题转为阴道手术。中位对接时间、控制台操作时间和总手术时间分别为11分钟(范围4-40分钟)、80分钟(范围20-240分钟)和122分钟(范围35-282分钟)。中位失血量为50ml(范围10-250ml)。未记录到转为腹腔镜/开腹手术的情况。21例患者接受了盆腔淋巴结清扫术(16.8%),中位盆腔淋巴结数为13个(范围3-32个)。中位出院时间为2天(范围1-3天)。术中未发生并发症,术后早期并发症观察到10例(8%)。
RSSH联合或不联合盆腔淋巴结清扫术在技术上是可行、安全且可重复的,可能是FIGO I-II期子宫内膜癌患者的治疗选择。然而,需要随机对照试验来证实这些结果。