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[LACC研究的影响。一项SFOG调查]

[Impact of the LACC study. A SFOG survey].

作者信息

Gauthier Tristan, Lacorre Aymeline, Sallee Camille, Tardieu Antoine, Guyon Frédéric, Margueritte François, Gouy Sébastien

机构信息

CHU Limoges, hôpital Mère-Enfant, service de gynécologie-obstétrique, 8, avenue Dominique-Larrey, 87042 Limoges, France.

CHU Limoges, hôpital Mère-Enfant, service de gynécologie-obstétrique, 8, avenue Dominique-Larrey, 87042 Limoges, France.

出版信息

Bull Cancer. 2020 May;107(5):551-555. doi: 10.1016/j.bulcan.2020.02.012. Epub 2020 Mar 31.

DOI:10.1016/j.bulcan.2020.02.012
PMID:32245607
Abstract

INTRODUCTION

The LACC (Laparoscopic Approach to Cervical Cancer Trial) study, released in 2018, described oncological findings in favour of open surgery compared to the minimally invasive pathway in the management of early stage cervical cancers. Our aim was to assess the impact of this study on surgical practices in France.

METHOD

Online questionnaire, consisting of 13 questions addressed to gynecology oncology french society (SFOG) surgeons.

RESULTS

Forty questionnaires were collected. The median annual number of radical hysterectomy was 5 (0-20). Prior to the study, 92.5 % of cervical cancer patients had radical hysterectomy by minimally invasive surgery. In case of laparoscopy or robot, the uterine manipulator was used in 67.6 % and the colpotomy was performed intra-abdominally (78.4 %). After the LACC study, 60 % changed their practice. Open surgery was favored by 75 % of those who modified their practice. Among those continuing to perform minimally invasive surgeries, the manipulator and the intracorporeal colpotomy were discontinued. One-third of surgeons have changed their surgical practice for endometrial cancer in parallel.

CONCLUSION

The results of the LACC study led to a change in surgical practices with an increase in open surgery and a stop in the use of the uterine manipulator and the laparoscopic/robotic intracorporeal colpotomy in the surgical management of early stage of cervical cancer.

摘要

引言

2018年发布的LACC(腹腔镜治疗宫颈癌试验)研究描述了在早期宫颈癌治疗中,与微创途径相比,开放手术在肿瘤学方面的优势。我们的目的是评估该研究对法国手术实践的影响。

方法

在线问卷,由13个问题组成,面向法国妇科肿瘤学会(SFOG)的外科医生。

结果

收集到40份问卷。根治性子宫切除术的年中位数为5例(0 - 20例)。在该研究之前,92.5%的宫颈癌患者通过微创手术进行根治性子宫切除术。在腹腔镜或机器人手术中,67.6%使用子宫操纵器,78.4%进行腹腔内阴道切开术。LACC研究之后,60%的人改变了他们的手术方式。改变手术方式的人中,75%倾向于开放手术。在继续进行微创手术的人中,不再使用操纵器和体内阴道切开术。三分之一的外科医生同时改变了他们对子宫内膜癌的手术方式。

结论

LACC研究的结果导致了手术方式的改变,在早期宫颈癌的手术治疗中,开放手术增加,子宫操纵器以及腹腔镜/机器人体内阴道切开术停止使用。

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