Goel Vipin, Khan Bushra, Rampelly Snigdha
Department of Surgical Oncology, Star Hospitals, Hyderabad, IND.
Cureus. 2024 Oct 15;16(10):e71525. doi: 10.7759/cureus.71525. eCollection 2024 Oct.
Background Laparoscopic hysterectomy is a substitute for the abdominal hysterectomy technique for endometrial carcinoma. Goel's technique is a unique laparoscopic hysterectomy. The main feature of Goel's technique is that vaginal manipulators or myoma screws are not used in the procedure as vaginal manipulators or myoma screws contribute to an increased risk of spread of malignancy in the systemic circulation. Methods In this retrospective, observational, pilot, single-centre study, the patient's baseline demographics, clinical characteristics, and assessment and outcome measures of Goel's technique of laparoscopic hysterectomy were recorded. The following metrics were used to assess the postoperative recovery: average time to discharge the patients after the surgery; postoperative complications/pain assessment; correlation between pain and day of hospital discharge; association between the day of discharge and postoperative pain assessment; association between operation time and complications. Results A total of 35 female patients with early-stage endometrial cancer were included, their mean age being 56.29 years. The mean time to hospital discharge of the patients was 2.94 days. Of the cases, 2.9% had a ureteral injury and ureterovaginal fistula as complications, which were resolved during the follow-up period. On day one, the mean pain score decreased significantly to 50% from day zero (D0), and on day two, the mean pain score showed a significant fall of 91.5% from D0. Ten patients with a mean pain assessment score of 3.60 at D0 were released on the second day, 20 patients with a mean score of 3.80 at D0 were released on the second day, and five patients with a mean score of 5.60 at D0 were released at ≥ four days. Not a single patient developed any wound infection, dehiscence, or herniation for six months. Conclusion Goel's technique helped patients with endometrial carcinoma to recover faster and it reduced hospital stays with fewer postoperative complications.
腹腔镜子宫切除术是子宫内膜癌腹部子宫切除技术的替代方法。戈尔技术是一种独特的腹腔镜子宫切除术。戈尔技术的主要特点是在手术过程中不使用阴道操纵器或肌瘤螺旋钻，因为阴道操纵器或肌瘤螺旋钻会增加恶性肿瘤在体循环中扩散的风险。方法：在这项回顾性、观察性、试点、单中心研究中，记录了患者的基线人口统计学、临床特征以及戈尔腹腔镜子宫切除技术的评估和结果指标。使用以下指标评估术后恢复情况：术后患者出院的平均时间；术后并发症/疼痛评估；疼痛与出院日期的相关性；出院日期与术后疼痛评估的关联；手术时间与并发症的关联。结果：共纳入35例早期子宫内膜癌女性患者，平均年龄为56.29岁。患者的平均出院时间为2.94天。其中2.9%的病例出现输尿管损伤和输尿管阴道瘘等并发症，在随访期间得到解决。第一天，平均疼痛评分较第零天（D0）显著下降至50%，第二天，平均疼痛评分较D0显著下降91.5%。第零天平均疼痛评估评分为3.60的10例患者在第二天出院，第零天平均评分为3.80的20例患者在第二天出院，第零天平均评分为5.60的5例患者在≥4天后出院。6个月内没有患者出现任何伤口感染、裂开或疝形成。结论：戈尔技术有助于子宫内膜癌患者更快康复，减少住院时间，术后并发症更少。
