Guo Xinmeng, Song Jiangnan, Tian Shuang, Li Weiping, Zhang Jinning, Yao Yuanqing
School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 300071, China.
Department of Obstetrics and Gynecology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Arch Gynecol Obstet. 2024 Dec;310(6):3047-3055. doi: 10.1007/s00404-024-07746-1. Epub 2024 Oct 30.
Cervical cancer is a common gynecological malignancy. However, the optimal surgical approach and benefits of uterine manipulator use remain unclear in this context. This study aimed to compare patient outcomes among different surgical approaches including laparoscopic, combined vaginal and laparoscopic, abdominal, and robotic using the da Vinci surgical system. Moreover, we also aimed to examine the impact of uterine manipulator use in radical hysterectomy on the outcomes of patients with cervical cancer.
This retrospective study included data from 848 patients with cervical cancer stage IA2-IIA2 that underwent a radical hysterectomy and pelvic lymphadenectomy at the Chinese PLA General Hospital between 2009 and 2019. Patient demographic and clinical characteristics, perioperative findings, and postoperative outcomes were examined.
Patient characteristics, including body mass index, age, FIGO stage, pathological type, and tumor differentiation status and size, were comparable. Five-year survival rates were comparable among the groups that underwent different types of surgery regardless of disease stage. Five-year survival rates were comparable between the groups that underwent surgery with and without the use of a uterine manipulator.
All surgical approaches examined in this study had comparable efficacy and safety profiles. The use of uterine manipulators during radical hysterectomy for cervical cancer does not increase the risk of death.
宫颈癌是一种常见的妇科恶性肿瘤。然而，在这种情况下，最佳手术方式以及使用子宫操纵器的益处仍不明确。本研究旨在比较不同手术方式（包括腹腔镜手术、经阴道与腹腔镜联合手术、开腹手术以及使用达芬奇手术系统的机器人手术）的患者结局。此外，我们还旨在研究在宫颈癌根治性子宫切除术中使用子宫操纵器对患者结局的影响。
这项回顾性研究纳入了2009年至2019年期间在中国人民解放军总医院接受根治性子宫切除术和盆腔淋巴结清扫术的848例IA2-IIA2期宫颈癌患者的数据。对患者的人口统计学和临床特征、围手术期发现以及术后结局进行了检查。
患者特征，包括体重指数、年龄、国际妇产科联盟（FIGO）分期、病理类型、肿瘤分化状态和大小，具有可比性。无论疾病分期如何，接受不同类型手术的组间五年生存率具有可比性。在使用和未使用子宫操纵器进行手术的组间，五年生存率具有可比性。
本研究中检查的所有手术方式具有相当的疗效和安全性。在宫颈癌根治性子宫切除术中使用子宫操纵器不会增加死亡风险。
