机器人手术在不同 BMI 患者子宫内膜癌治疗中的价值。
Value of robotic surgery in endometrial cancer by body mass index.
机构信息
José Botella Llusiá Institute of Women's Health, Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University of Madrid, Madrid, Spain.
出版信息
Int J Gynaecol Obstet. 2020 Sep;150(3):398-405. doi: 10.1002/ijgo.13258. Epub 2020 Jun 22.
OBJECTIVE
To compare perioperative outcomes and complications in robotically assisted laparoscopy (RAL) and standard laparoscopy (SLP) approaches in the treatment of endometrial cancer by body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters).
METHODS
A comparative study was carried out of women treated for endometrial cancer at the Hospital Clinico San Carlos from January 2012 to December 2016: 133 patients were operated by RAL and 101 by SLP. Demographic characteristics of the patients, perioperative outcomes and complications were compared in both approaches.
RESULTS
Hospital stay was significantly lower in patients with BMI ≤30 operated with RAL (2 days RAL vs 4 days SLP; P=0.002). Estimated blood loss was significantly lower in the group with BMI<25 (60 mL RAL vs 100 mL SLP; P=0.004) and in the group with BMI ≥30 (87.5 mL RAL vs 180 SLP; P=0.003) operated with RAL. RAL significantly reduced the conversion rate in patients with BMI ≥30 (2 [3.4%] patients RAL vs 6 [27.3%] patients SLP; P=0.004).
CONCLUSIONS
RAL has demonstrated advantages in treating obese women with endometrial cancer by reducing blood loss and conversion to laparotomy.
目的
通过体重指数（BMI，体重以千克为单位除以身高以米为单位的平方）比较机器人辅助腹腔镜（RAL）和标准腹腔镜（SLP）治疗子宫内膜癌的围手术期结果和并发症。
方法
对 2012 年 1 月至 2016 年 12 月在圣卡洛斯临床医院治疗的子宫内膜癌患者进行了一项比较研究：133 例患者接受 RAL 手术，101 例患者接受 SLP 手术。比较两种方法的患者人口统计学特征、围手术期结果和并发症。
结果
BMI≤30 接受 RAL 手术的患者住院时间明显更短（RAL 2 天 vs SLP 4 天；P=0.002）。BMI<25 的患者（RAL 60 毫升 vs SLP 100 毫升；P=0.004）和 BMI≥30 的患者（RAL 87.5 毫升 vs SLP 180 毫升；P=0.003）的估计出血量明显更低接受 RAL 手术。RAL 在 BMI≥30 的患者中显著降低了中转开腹率（RAL 2 [3.4%]例患者 vs SLP 6 [27.3%]例患者；P=0.004）。
结论
RAL 通过减少出血量和中转开腹率，在治疗肥胖的子宫内膜癌患者方面具有优势。
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