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学习腹腔镜根治性子宫切除术:我们是否面临新的局面?

Learning Laparoscopic Radical Hysterectomy: Are We Facing an Emerging Situation?

机构信息

Department of Obstetrics and Gynecology, Lebanese American University Medical Center-Rizk Hospital, Beirut 1100, Lebanon.

Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.

出版信息

Int J Environ Res Public Health. 2023 Jan 22;20(3):2053. doi: 10.3390/ijerph20032053.

Abstract

Despite wide screening campaigns and early detection, cervical cancer remains the fourth most common cancer among women. Radical hysterectomy, whether by open, laparoscopic or by robotic-assisted techniques, is the mainstay treatment. However, for adequate surgical results and good oncological prognosis, a gynecological surgeon should be trained to perform those procedures. The learning curve of radical hysterectomy, especially by laparoscopy, is influenced by several factors. The LACC trial, the decrease in cervical cancer incidence and radical hysterectomy procedures have widely reduced the learning curve for surgeons. This article mainly discusses the learning curve of laparoscopic radical hysterectomy for cervical cancers, and how several factors are influencing it negatively, with the need to have medical authorities reset specific surgical training programs and allocate them to special oncological centers.

摘要

尽管进行了广泛的筛查活动和早期检测,宫颈癌仍然是女性中第四常见的癌症。根治性子宫切除术,无论是开放性、腹腔镜还是机器人辅助技术,都是主要的治疗方法。然而,为了获得足够的手术效果和良好的肿瘤预后,妇科医生应该接受过这些手术的培训。根治性子宫切除术的学习曲线,特别是腹腔镜手术,受到多种因素的影响。LACC 试验以及宫颈癌发病率和根治性子宫切除术的减少,大大缩短了外科医生的学习曲线。本文主要讨论了腹腔镜宫颈癌根治术的学习曲线,以及有哪些因素会对其产生负面影响,并需要医疗当局重新设定特定的手术培训计划,并将其分配到专门的肿瘤中心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bde/9915887/57e42a5b4a9e/ijerph-20-02053-g001.jpg

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