Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
J Gynecol Oncol. 2023 Nov;34(6):e68. doi: 10.3802/jgo.2023.34.e68. Epub 2023 May 31.
This study aimed to validate the surgical and oncologic outcomes of robotic surgery with sentinel node navigation surgery (SNNS) in endometrial cancer.
This study included 130 patients with endometrial cancer, who underwent robotic surgery, including hysterectomy, bilateral salpingo-oophorectomy, and pelvic SNNS at the Department of Obstetrics and Gynecology of Kagoshima University Hospital. Pelvic sentinel lymph nodes (SLNs) were identified using the uterine cervix 99m Technetium-labeled phytate and indocyanine green injections. Surgery-related and survival outcomes were also evaluated.
The median operative and console times and volume of blood loss were 204 (range: 101-555) minutes, 152 (range: 70-453) minutes, and 20 (range: 2-620) mL, respectively. The bilateral and unilateral pelvic SLN detection rates were 90.0% (117/130) and 5.4% (7/130), respectively, and the identification rate (the rate at which at least one SLN could be identified on either side) was 95% (124/130). Lower extremity lymphedema occurred in only 1 patient (0.8%), and no pelvic lymphocele occurred. Recurrence occurred in 3 patients (2.3%), and the recurrence site was the abdominal cavity, with dissemination in 2 patients and vaginal stump in one. The 3-year recurrence-free survival and 3-year overall survival rates were 97.1% and 98.9%, respectively.
Robotic surgery with SNNS for endometrial cancer showed a high SLN identification rate, low occurrence rates of lower extremity lymphedema and pelvic lymphocele, and excellent oncologic outcomes.
本研究旨在验证机器人手术联合前哨淋巴结导航手术（SNNS）治疗子宫内膜癌的手术和肿瘤学结果。
本研究纳入了在鹿儿岛大学医院妇产科接受机器人手术治疗的 130 例子宫内膜癌患者，手术包括子宫切除术、双侧输卵管卵巢切除术和盆腔 SNNS。使用宫颈 99m 锝标记植酸钠和吲哚菁绿注射来识别盆腔前哨淋巴结（SLNs）。还评估了手术相关和生存结果。
中位手术和控制台时间以及出血量分别为 204（范围：101-555）分钟、152（范围：70-453）分钟和 20（范围：2-620）mL。双侧和单侧盆腔 SLN 检测率分别为 90.0%（117/130）和 5.4%（7/130），识别率（至少在一侧可以识别到一个 SLN 的比率）为 95%（124/130）。只有 1 例患者（0.8%）出现下肢淋巴水肿，无盆腔淋巴囊肿发生。3 例患者（2.3%）出现复发，复发部位为腹腔，2 例为播散性，1 例为阴道残端。3 年无复发生存率和 3 年总生存率分别为 97.1%和 98.9%。
机器人手术联合 SNNS 治疗子宫内膜癌具有较高的 SLN 识别率，下肢淋巴水肿和盆腔淋巴囊肿发生率低，且具有良好的肿瘤学结果。
