Bahadur Anupama, Sharma Shloka, Heda Ayush, Chawla Latika, Mundhra Rajlaxmi
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Minim Access Surg. 2024 Jul 30. doi: 10.4103/jmas.jmas_125_24.
Robot-assisted surgeries are increasingly used for the treatment of benign gynaecological conditions. However, their impact in cases of significantly enlarged uteruses remains uncertain. This study aims to investigate whether the weight of the uterus influences the surgical results of robotic hysterectomy.
Ambispective analysis of 306 cases was performed, of which 265 cases were analysed retrospectively. The outcome measures included total operative time, including docking time, console time and vault closure time, complication rates and quality of life (World Health Organization Quality of Life Brief questionnaire) stratified based on uterine sizes into three groups by every 250 g.
Of the 306 cases, 76.47% of cases (n = 234) had uterine weight <250 g, 18.30% of cases (n = 56) had uterine weight between 250 and 500 g, while 5.23% of cases (n = 16) had a weight of uterine specimen >500 g. The total operative time was significantly lower in the <250 g group compared to >500 g (81.92 ± 22.81 vs. 111.88 ± 40.27 min; P = 0.003), contributed primarily by the console time. Although the need for post-operative blood transfusion was higher in the >500 g group, the overall complication rate between the three groups was similar. The three groups had comparable QOL through all four domains.
The present study underscores the influence of uterine weight on robotic hysterectomy outcomes, revealing increased operative times and post-operative haemoglobin drop for uteri over 500 g. Despite these challenges, complications were not significantly affected by uterine size.
机器人辅助手术越来越多地用于治疗妇科良性疾病。然而，其在子宫明显增大的病例中的影响仍不确定。本研究旨在调查子宫重量是否会影响机器人子宫切除术的手术结果。
对306例病例进行双向分析，其中265例进行回顾性分析。结局指标包括总手术时间，包括对接时间、控制台操作时间和阴道顶端闭合时间、并发症发生率以及生活质量（世界卫生组织生活质量简表），根据子宫大小每250g分为三组。
在306例病例中，76.47%（n = 234）的子宫重量<250g，18.30%（n = 56）的子宫重量在250至500g之间，而5.23%（n = 16）的子宫标本重量>500g。<250g组的总手术时间显著低于>500g组（81.92±22.81 vs. 111.88±40.二十七分钟；P = 0.003），主要是由控制台操作时间导致。虽然>500g组术后输血的需求更高，但三组之间的总体并发症发生率相似。三组在所有四个领域的生活质量相当。
本研究强调了子宫重量对机器人子宫切除术结果的影响，显示子宫重量超过500g时手术时间增加且术后血红蛋白下降。尽管存在这些挑战，但并发症并未受到子宫大小的显著影响。
