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评估机器人手术在妇科癌症治疗中的作用。

Evaluating the role of robotic surgery in gynecological cancer treatment.

作者信息

Čelebić Aleksandar, Jakimovska Stefanovska Marina, Miladinović Mirjana, Calleja-Agius Jean, Starič Kristina Drusany

机构信息

Medical School, University of Montenegro, Podgorica, Montenegro; Institute of Oncology, Clinical Center of Montenegro, Podgorica, Montenegro.

Division of Gynecology and Obstetrics, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.

出版信息

Eur J Surg Oncol. 2025 Apr;51(4):109630. doi: 10.1016/j.ejso.2025.109630. Epub 2025 Jan 28.

Abstract

Robotic surgery has emerged as a transformative force in the field of gynecologic oncology, offering a minimally invasive yet versatile approach to managing a wide range of gynecologic cancers. Robotic platforms, with their enhanced precision, magnified visualization, and ergonomic advantages, have been translated into tangible benefits for patients, including reduced blood loss, shorter hospital stays, and faster recovery times. In the context of endometrial cancer, robotic-assisted hysterectomy has become an increasingly preferred approach for early-stage disease, demonstrating comparable, if not superior, surgical and oncologic outcomes compared to traditional open or laparoscopic methods across various histopathological subtypes. Similarly, robotic surgery has gained traction in the treatment of early-stage cervical cancer, with robotic-assisted radical hysterectomy offering a minimally invasive alternative with favorable early results. However, recent studies highlighting the importance of long-term survival data underscores the need for ongoing research and careful patient selection. While the role of robotic surgery in advanced ovarian cancer remains less definitive compared to endometrial and cervical cancers, ongoing research is exploring its potential benefits in specific scenarios, such as interval debulking surgery and patients with limited disease burden. Despite its demonstrable advantages, robotic surgery in gynecologic oncology is not without its challenges, including the high initial cost, the need for specialized surgical training, and the inherent limitations of robotic platforms. However, as technology continues to advance and surgical expertise grows, robotic surgery holds immense promise for further refining the surgical management of gynecologic cancers, ultimately striving to provide all women facing these diseases with the most effective, safest, and compassionate care possible.

摘要

机器人手术已成为妇科肿瘤学领域的一股变革力量,为处理各种妇科癌症提供了一种微创且多功能的方法。机器人平台凭借其更高的精准度、放大的可视化效果和人体工程学优势,已为患者带来了切实的益处,包括减少失血、缩短住院时间和加快恢复速度。在子宫内膜癌方面,机器人辅助子宫切除术已成为早期疾病越来越受欢迎的方法,与传统开放或腹腔镜手术方法相比,在各种组织病理学亚型中显示出相当甚至更优的手术和肿瘤学结果。同样,机器人手术在早期宫颈癌的治疗中也越来越受到关注,机器人辅助根治性子宫切除术提供了一种微创替代方案,早期效果良好。然而,最近强调长期生存数据重要性的研究凸显了持续研究和谨慎选择患者的必要性。虽然与子宫内膜癌和宫颈癌相比,机器人手术在晚期卵巢癌中的作用仍不太明确,但正在进行的研究正在探索其在特定情况下的潜在益处,如间隔减瘤手术和疾病负担有限的患者。尽管机器人手术具有明显优势,但妇科肿瘤学中的机器人手术也并非没有挑战,包括高昂的初始成本、对专业手术培训的需求以及机器人平台的固有局限性。然而,随着技术不断进步和手术专业知识的增长,机器人手术有望进一步完善妇科癌症的手术管理,最终努力为所有面临这些疾病的女性提供最有效、最安全和最具同情心的护理。

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