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机器人辅助子宫切除术与传统腹腔镜子宫切除术治疗中国宫颈癌患者的安全性和有效性。

Safety and effectiveness of robotic hysterectomy versus conventional laparoscopic hysterectomy in patients with cervical cancer in China.

机构信息

Department of Gynecology and Obstetrics, Gansu Provincial Hospital, No. 204, West Donggang Road, Lanzhou, 730000, People's Republic of China.

Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, People's Republic of China.

出版信息

Arch Gynecol Obstet. 2019 Jul;300(1):153-160. doi: 10.1007/s00404-019-05148-2. Epub 2019 Apr 21.

Abstract

OBJECTIVE

The aim of this study was to compare the safety and effectiveness of robotic hysterectomy (RH) with conventional laparoscopic hysterectomy (LH) for the treatment of cervical cancer using multivariate regressions.

METHODS

We designed a retrospective single-center study and consecutively collected patients with cervical cancer from February 2014 to October 2017. Data extraction was performed by two independent researchers. The surgical outcomes include operative time, estimated blood loss, number of lymph nodes, time to first flatus, time to a full diet, time to remove drainage tube, length of hospital stay, and postoperative complication.

RESULTS

A total of 152 patients with cervical cancer were collected in our study including 92 patients who underwent RH and 60 patients who underwent LH. Both groups have similar characteristics. The RH group showed shorter operative time (Coe - 42.89; 95% CI - 74.39 to 11.39; P = 0.008) and more number of lymph nodes (Coe 6.06; 95% CI 2.46-9.66; p = 0.001) than the LH group. As for the postoperative parameters, the RH group showed shorter time to remove drainage tube (Coe - 0.89; 95% CI -1.62 to -0.15; p = 0.019) and length of hospital stay (Coe - 6.40; 95% CI - 10.19 to - 2.95; p = 0.001). No significant difference was found between the groups in estimated blood loss (Coe 34.64; 95% CI - 33.08 to 102.37; p = 0.314), time to first flatus (Coe 0.11; 95% CI - 0.38 to 0.61; p = 0.652), time to a full diet (Coe - 0.24; 95% CI - 0.54 to 0.06, p = 0.118), and postoperative complication (OR 0.84; 95% CI 0.35-1.98; p = 0.685).

CONCLUSION

The results from this study suggest that RH is safe and effective as LH but robotic surgery significantly contributed to the feasibility of alternative treatment options for cervical cancer patients.

摘要

目的

本研究旨在使用多元回归比较机器人辅助子宫切除术(RH)与传统腹腔镜子宫切除术(LH)治疗宫颈癌的安全性和有效性。

方法

我们设计了一项回顾性单中心研究,并连续收集了 2014 年 2 月至 2017 年 10 月期间患有宫颈癌的患者。数据由两名独立研究员进行提取。手术结果包括手术时间、估计失血量、淋巴结数量、首次排气时间、全饮食时间、引流管去除时间、住院时间和术后并发症。

结果

本研究共纳入 152 例宫颈癌患者,其中 92 例行 RH,60 例行 LH。两组患者的特征相似。RH 组的手术时间明显更短(Coe-42.89;95%CI-74.39 至 11.39;P=0.008),淋巴结数量更多(Coe6.06;95%CI2.46-9.66;p=0.001)。在术后参数方面,RH 组引流管去除时间更短(Coe-0.89;95%CI-1.62 至-0.15;p=0.019),住院时间更短(Coe-6.40;95%CI-10.19 至-2.95;p=0.001)。两组患者在估计失血量(Coe34.64;95%CI-33.08 至 102.37;p=0.314)、首次排气时间(Coe0.11;95%CI-0.38 至 0.61;p=0.652)、全饮食时间(Coe-0.24;95%CI-0.54 至 0.06;p=0.118)和术后并发症(OR0.84;95%CI0.35-1.98;p=0.685)方面无显著差异。

结论

本研究结果表明,RH 与 LH 一样安全有效,但机器人手术显著提高了宫颈癌患者替代治疗方案的可行性。

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