Lim Chul Kwon, Kim Dae Yeon, Cho Angela, Choi Ji-Yeong, Park Jeong-Yeol, Kim Yong-Man
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Gland Surg. 2021 Mar;10(3):1252-1259. doi: 10.21037/gs-2019-ursoc-07.
Despite having revolutionized the management of multiple types of gynecologic cancers laparoscopy and robotic surgery have had limited utility in ovarian cancer until recently. The development in medical technology allows surgeons to perform minimally invasive surgery (MIS) not only in early ovarian cancer, but also in advanced ovarian cancer. Thus far, most prospective studies showed feasible results of MIS in ovarian cancer. Even with many proven advantages of the MIS, there is no concrete evidence of the disparity in survival rate between laparoscopic, robotic surgery and laparotomy surgery. We reviewed the results of MIS in ovarian cancer thus far and suggest how the gynecologists can apply MIS in ovarian cancer in the future. Until the further prospective studies show solid evidence of safety in the MIS in ovarian cancer, comprehensive discussion about the benefits and risk with the patient and the level of surgical skill of the gynecologist should be considered in determining the type of surgery.
尽管腹腔镜手术和机器人手术彻底改变了多种妇科癌症的治疗方式,但直到最近,它们在卵巢癌治疗中的应用仍较为有限。医学技术的发展使外科医生不仅能够对早期卵巢癌,而且也能对晚期卵巢癌实施微创手术(MIS)。迄今为止,大多数前瞻性研究表明MIS在卵巢癌治疗中取得了可行的结果。即便MIS有诸多已被证实的优势,但尚无确凿证据表明腹腔镜手术、机器人手术与开腹手术在生存率上存在差异。我们回顾了迄今为止MIS在卵巢癌治疗中的结果,并就未来妇科医生如何在卵巢癌治疗中应用MIS提出建议。在进一步的前瞻性研究提供确凿证据证明MIS在卵巢癌治疗中的安全性之前,在确定手术方式时,应与患者就益处和风险进行全面讨论,并考虑妇科医生的手术技能水平。