Sun Hao, Gao Jinghai, Jin Zhijin, Wu Yuxian, Zhou Yang, Liu Xiaojun
Department of Gynaecology and Obstetrics, Shanghai Changzheng Hospital, Shanghai, China.
Wideochir Inne Tech Maloinwazyjne. 2021 Sep;16(3):597-603. doi: 10.5114/wiitm.2021.103955. Epub 2021 Feb 26.
Laparoendoscopic single-site surgery (LESS) can reduce the limited invasiveness of conventional laparoscopy while providing superior cosmetic results. Robotic single-site surgery (RSSS) can overcome this shortcoming to a certain extent.
To evaluate the advantages of RSSS in treating early-stage endometrial cancer by comparing RSSS with LESS.
From January 2018 to August 2018, patients diagnosed with endometrial cancer from endometrial curettage and imaging studies were selected for this prospective cohort study, with 22 undergoing RSSS and 18 undergoing LESS. All surgical procedures were performed using the conventional da Vinci Si surgical system with the Lagiport single port or a conventional laparoendoscopic instrument with the Lagiport single port. Operative time was recorded electronically. Intraoperative parameters and postoperative parameters were recorded and further analyzed.
The operation was successfully completed, and a pure single-point approach was adopted. There were no laparotomy or intraoperative complications. Compared with the LESS group, the RSSS group had significantly longer pre-surgical time, significantly lower median operation time, significantly lower median blood loss, and significantly lower vaginal cuff closure time. The median length of hospital stay in the RSSS group was significantly lower than that in the LESS group. There was no significant difference in the incidence of early and late complications between the two groups. No recurrence events were observed in either the RSSS or the LESS group.
RSSS is feasible and safe in patients with early-stage endometrial cancer. RSSS can reduce operating time, blood loss and length of hospital stay compared with LESS.
经自然腔道内镜手术(LESS)在减少传统腹腔镜手术侵入性的同时,能提供更好的美容效果。机器人单孔手术(RSSS)在一定程度上可以克服这一缺点。
通过比较RSSS和LESS,评估RSSS治疗早期子宫内膜癌的优势。
选取2018年1月至2018年8月间经子宫内膜刮除术及影像学检查确诊为子宫内膜癌的患者进行这项前瞻性队列研究,其中22例行RSSS,18例行LESS。所有手术均使用配备Lagiport单孔的传统达芬奇Si手术系统或配备Lagiport单孔的传统腹腔镜器械进行。手术时间通过电子方式记录。记录术中参数和术后参数并进行进一步分析。
手术均成功完成,均采用了纯单点入路。无开腹手术或术中并发症。与LESS组相比,RSSS组术前准备时间显著更长,中位手术时间显著更短,中位失血量显著更低,阴道残端闭合时间显著更低。RSSS组的中位住院时间显著低于LESS组。两组早期和晚期并发症发生率无显著差异。RSSS组和LESS组均未观察到复发事件。
RSSS用于早期子宫内膜癌患者可行且安全。与LESS相比,RSSS可减少手术时间、失血量和住院时间。