机器人辅助腹腔镜和阴道子宫切除术治疗子宫内膜增生和子宫内膜癌的病态肥胖患者。
Robotic-assisted, laparoscopic, and vaginal hysterectomy in morbidly obese patients with endometrial hyperplasia and endometrial cancer.
机构信息
Unit of Gynecology, Sant'Andrea Hospital, Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy.
Obstetrics and Gynecological Unit, Department of Woman's and Child's Health, San Camillo-Forlanini Hospital, Rome, Italy.
出版信息
Minim Invasive Ther Allied Technol. 2024 Dec;33(6):358-364. doi: 10.1080/13645706.2024.2407845. Epub 2024 Sep 28.
BACKGROUND
Hysterectomy for endometrial hyperplasia and endometrial cancer in morbidly obese patients is challenging. Here, we reported data regarding three minimally invasive approaches.
METHOD
This is a multicenter retrospective study evaluating 30-day and 90-day surgery-related outcomes of morbidly obese patients (those with BMI > 40kg/m) undergoing robotic-assisted, laparoscopic, and vaginal hysterectomy.
RESULTS
Charts of 95 morbidly obese patients who underwent surgery for endometrial cancer were retrieved. Overall, robotic-assisted, laparoscopic, and vaginal surgeries were performed in 35 (36.8%), 38 (40%), and 22 (23.2%) patients, respectively. Patients having robotic-assisted surgery experienced longer operative time than patients having vaginal and laparoscopic approaches ( < 0.001). Surgical approaches did not influence the risk of having intraoperative and severe (Clavien-Dindo grade 3 or more) postoperative complications. No 90-day mortality occurred.
CONCLUSIONS
Robotic-assisted, laparoscopic, and vaginal surgery represent three safe and feasible minimally invasive approaches to manage morbidly obese patients with endometrial hyperplasia and endometrial cancer.
背景
病态肥胖患者的子宫内膜增生和子宫内膜癌的子宫切除术具有挑战性。在这里，我们报告了三种微创方法的数据。
方法
这是一项多中心回顾性研究，评估了接受机器人辅助、腹腔镜和阴道子宫切除术的病态肥胖患者（BMI>40kg/m）的 30 天和 90 天手术相关结局。
结果
检索了 95 例因子宫内膜癌接受手术的病态肥胖患者的图表。总体而言，分别有 35 例（36.8%）、38 例（40%）和 22 例（23.2%）患者接受了机器人辅助手术、腹腔镜手术和阴道手术。与阴道和腹腔镜方法相比，接受机器人辅助手术的患者手术时间更长（<0.001）。手术方法并不影响术中并发症和严重（Clavien-Dindo 分级 3 级或更高级别）术后并发症的风险。无 90 天死亡。
结论
机器人辅助、腹腔镜和阴道手术是治疗病态肥胖患者子宫内膜增生和子宫内膜癌的三种安全可行的微创方法。
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