Zanagnolo Vanna, Garbi Annalisa, Achilarre Maria Teresa, Minig Lucas
Gynecology Department, European Institute of Oncology, Milan, Italy.
Gynecology Department, European Institute of Oncology, Milan, Italy.
J Minim Invasive Gynecol. 2017 Mar-Apr;24(3):379-396. doi: 10.1016/j.jmig.2017.01.006. Epub 2017 Jan 16.
Robotic-assisted surgery is a technological advancement that facilitates the application of minimally invasive techniques for complex operations in gynecologic oncology. The objective of this article was to review the literature regarding the role of robotic-assisted surgery to treat women with gynecologic cancers. The majority of publications on robotic surgery are still retrospective or descriptive in nature; however, the data for managing patients with a robotic-assisted approach show comparable, and at times improved, outcomes compared with both laparoscopy (2-dimensional) and laparotomy approaches. Robotic-assisted surgery has been used for patients with endometrial cancer and resulted in the increased use of minimally invasive surgery with improved outcomes compared with laparotomy and partially with laparoscopy. This has been shown in large cohorts of patients as well as in obese patients in whom the complication rates have significantly decreased. For early cervical cancer, robotic radical hysterectomy seems to be safe and feasible and to be preferable to laparotomy with seemingly comparable oncologic outcomes. Robotic-assisted surgery and conventional laparoscopy to stage women with early-stage ovarian cancer seem to have similar surgical and oncologic outcomes, with a shorter learning curve for robotic-assisted surgery. However, robotic-assisted surgery appears to be more expensive than laparotomy and traditional laparoscopy. In conclusion, robotic-assisted surgery appears to facilitate the surgical approach for complex operations to treat women with gynecologic cancers. Although randomized controlled trials are lacking to further elucidate the equivalence of robot-assisted surgery with conventional methods in terms of oncologic outcome and patients' quality of life, the technology appears to be safe and effective and could offer a minimally invasive approach to a much larger group of patients.
机器人辅助手术是一项技术进步，它有助于在妇科肿瘤学的复杂手术中应用微创技术。本文的目的是回顾有关机器人辅助手术在治疗妇科癌症女性患者中作用的文献。大多数关于机器人手术的出版物本质上仍是回顾性或描述性的；然而，与腹腔镜手术（二维）和开腹手术方法相比，采用机器人辅助方法管理患者的数据显示出相当的，有时甚至更好的结果。机器人辅助手术已用于子宫内膜癌患者，与开腹手术相比，微创手术的使用增加，结果得到改善，部分与腹腔镜手术相比也是如此。这在大量患者队列以及肥胖患者中得到了证实，肥胖患者的并发症发生率显著降低。对于早期宫颈癌，机器人根治性子宫切除术似乎是安全可行的，并且比开腹手术更可取，肿瘤学结果似乎相当。对于早期卵巢癌患者进行分期，机器人辅助手术和传统腹腔镜手术似乎具有相似的手术和肿瘤学结果，机器人辅助手术的学习曲线更短。然而，机器人辅助手术似乎比开腹手术和传统腹腔镜手术更昂贵。总之，机器人辅助手术似乎有助于采用手术方法治疗患有妇科癌症的女性患者进行复杂手术。尽管缺乏随机对照试验来进一步阐明机器人辅助手术与传统方法在肿瘤学结果和患者生活质量方面的等效性，但该技术似乎是安全有效的，并且可以为更多患者提供微创方法。
