Planque H, Martin-Françoise S, Lequesne J, Le Brun J F
Service de chirurgie cancérologique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
Service de recherche clinique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
Gynecol Obstet Fertil Senol. 2018 Sep;46(9):625-631. doi: 10.1016/j.gofs.2018.07.002. Epub 2018 Aug 13.
Minimally invasive surgery is a technique frequently used in gynecologic surgery. The robot-assisted surgery is a recent approach, and the benefits are not yet proven. The objective of this study was to evaluate the feasibility to use robot-assisted surgery for obese patient with endometrial cancer.
All patients undergoing a robotic surgery for uterus malignant indication between March 2013 and May 2016 in our center were retrospectively included. Patients were divided in two groups, according to their body mass index (BMI). The group with BMI<30kg/m was the reference for this comparative study. The main criteria was the robot operative time. The other criteria were total operating time, hospital stay and intraoperative and postoperative complications.
Seventy-seven patients met inclusion criteria for analysis. The median robot operative time was 110minutes for all patients [21-341], without difference between the five groups (P=0.60). There was no difference for the total operative time (P=0.50). The median hospital stay was 3 days (P=0.92). There were ten intraoperative complications. One patient had a conversion (1.3%). There was no statistical difference for postoperative complications (P=1).
Our study found few differences in the surgical management by laparoscopic robot-assisted between obese and non obese women. Robot-assisted surgery seems to be feasible for uterine cancer treatment of obese patients. Prospective and randomized studies are needed to assess the benefit of the robotic surgery.
微创手术是妇科手术中常用的技术。机器人辅助手术是一种新方法，其益处尚未得到证实。本研究的目的是评估对肥胖子宫内膜癌患者使用机器人辅助手术的可行性。
回顾性纳入2013年3月至2016年5月在本中心因子宫恶性指征接受机器人手术的所有患者。根据体重指数（BMI）将患者分为两组。BMI<30kg/m²的组作为本比较研究的参照组。主要标准是机器人手术时间。其他标准包括总手术时间、住院时间以及术中及术后并发症。
77例患者符合纳入分析标准。所有患者的机器人手术时间中位数为110分钟[21 - 341]，五组之间无差异（P = 0.60）。总手术时间无差异（P = 0.50）。住院时间中位数为3天（P = 0.92）。有10例术中并发症。1例患者中转开腹（1.3%）。术后并发症无统计学差异（P = 1）。
我们的研究发现肥胖和非肥胖女性在腹腔镜机器人辅助手术管理方面差异不大。机器人辅助手术似乎对肥胖患者子宫癌治疗可行。需要进行前瞻性随机研究以评估机器人手术的益处。
