Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Eur J Obstet Gynecol Reprod Biol. 2021 Jul;262:62-67. doi: 10.1016/j.ejogrb.2021.05.003. Epub 2021 May 4.
To identify factors that prolong total operative time (TOT) in robotic-assisted laparoscopic myomectomy (RALM).
Retrospective cohort study.
Tertiary university hospital.
Women who underwent RALM between April 2009 and May 2019 conducted by a single high-volume gynecologic surgeon.
Patients' demographic data and intraoperative records were obtained. The association between the perioperative characteristics and TOT was analyzed.
A total of 584 cases met the inclusion criteria, with a mean TOT of 231.6 ± 86.7 min. The mean patient age was 36.3 ± 5.5 years, and the patients had a mean of 4.2 ± 4.0 myomas. The dominant myoma had a mean diameter of 7.6 ± 2.6 cm. The mean total weight of the extracted myomas removed was 202.2 ± 152.6 g. From multiple regression analysis, the following perioperative factors were intimately associated with the TOT: ① body mass index, ② the number of myomas, ③ weight of total myomas, ④ location of dominant myoma, ⑤ type of da Vinci robot system, ⑥ endometrial cavity opening during the operation, ⑦ intraoperative blood loss, and ⑧ patient hospitalization period. The number of myoma was most closely related to the TOT, with an R value of 0.330. All of the above factors with the exception of the type of robot system and location of dominant myoma were related to the console time. Age, parity, history of previous abdominal surgery, surgical indication, diameter, and FIGO classification were not associated with the TOT.
With an accurate identification of the perioperative parameters above, we can improve the quality of RALM by counselling, selecting an appropriate patient selection, and preoperative planning.
确定影响机器人辅助腹腔镜子宫肌瘤剔除术（RALM）总手术时间（TOT）的因素。
回顾性队列研究。
三级大学医院。
2009 年 4 月至 2019 年 5 月间由一名高年资妇科医生行 RALM 的女性患者。
获取患者的人口统计学数据和术中记录。分析围手术期特征与 TOT 之间的关系。
共纳入 584 例符合条件的患者，TOT 平均为 231.6±86.7min。患者平均年龄为 36.3±5.5 岁，平均肌瘤数为 4.2±4.0 个。最大肌瘤的平均直径为 7.6±2.6cm。切除肌瘤的总重量平均为 202.2±152.6g。多元回归分析显示，以下围手术期因素与 TOT 密切相关：①体重指数，②肌瘤数量，③总肌瘤重量，④最大肌瘤位置，⑤达芬奇机器人系统类型，⑥手术期间宫腔开口，⑦术中出血量，⑧患者住院时间。肌瘤数量与 TOT 最密切相关，R 值为 0.330。除机器人系统类型和最大肌瘤位置外，所有上述因素均与控制台时间相关。年龄、产次、既往腹部手术史、手术指征、肌瘤直径和 FIGO 分类与 TOT 无关。
通过准确识别上述围手术期参数，可以通过咨询、选择合适的患者选择和术前计划来提高 RALM 的质量。
