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子宫内膜癌前哨淋巴结活检的手术途径:腹腔镜手术与机器人辅助手术对比

Route of Surgery for Sentinel Node Biopsy in Endometrial Cancer: Laparoscopy Versus Robotics.

作者信息

Fierro Angela, Flores Isabel, Pellicer Irene, Alonso-Espias Maria, Garcia-Pineda Virginia, Zapardiel Ignacio, Gracia Myriam

机构信息

Gynecologic Oncology Unit, La Paz University Hospital, 28046 Madrid, Spain.

Gynecologic Oncology Unit, La Linea University Hospital, 11300 Cadiz, Spain.

出版信息

J Clin Med. 2025 Jun 6;14(12):4013. doi: 10.3390/jcm14124013.

Abstract

: Sentinel lymph node (SLN) mapping is an accepted technique for the nodal staging of early-stage endometrial cancer. It is carried out commonly by minimally invasive approach, either by laparoscopy or robotics-assisted surgery. The primary aim of this study was to compare the detection rate of SLN mapping between laparoscopic and robotic surgery. : A retrospective observational study including patients operated on from February 2024 to March 2025, diagnosed with endometrial cancer who underwent hysterectomy, bilateral salpingo-oophorectomy and SLN mapping. Among a total of 60 patients, 38 (63.3%) underwent laparoscopic surgery and 22 (36.7%) robotic surgery. We compared SLN detection rate and perioperative outcomes between the two routes of approach. : No significant differences were observed in the overall and bilateral SLN detection rate between laparoscopic and robotic surgery (97.3% and 84.2% vs. 95.5% and 91%, respectively). Significant differences were observed in operative time, with a median of 125 vs. 110 min ( = 0.004), and in hospital stay, with a median of 3 vs. 2 days ( = 0.002), with both being shorter in the robotic surgery group. No differences were observed in terms of number of SLN detected, percentage of positive nodes, intra or postoperative complications rate, or percentage of conversion to laparotomy. : No differences were found in SLN detection rates between laparoscopic and robotic surgery. However, robotic surgery demonstrated advantages in terms of reduced operative time and shorter hospital stay.

摘要

前哨淋巴结(SLN) mapping是早期子宫内膜癌淋巴结分期的一种公认技术。它通常通过微创方法进行,即通过腹腔镜或机器人辅助手术。本研究的主要目的是比较腹腔镜手术和机器人手术在前哨淋巴结mapping检测率方面的差异。:一项回顾性观察研究,纳入了2024年2月至2025年3月接受手术的患者,这些患者被诊断为子宫内膜癌,接受了子宫切除术、双侧输卵管卵巢切除术和前哨淋巴结mapping。在总共60例患者中,38例(63.3%)接受了腹腔镜手术,22例(36.7%)接受了机器人手术。我们比较了两种手术途径在前哨淋巴结检测率和围手术期结果方面的差异。:在腹腔镜手术和机器人手术之间,总体和双侧前哨淋巴结检测率没有观察到显著差异(分别为97.3%和84.2% vs. 95.5%和91%)。在手术时间方面观察到显著差异,中位数分别为125分钟和110分钟(P = 0.004),住院时间也有显著差异,中位数分别为3天和2天(P = 0.002),机器人手术组的这两项指标均较短。在前哨淋巴结检测数量、阳性淋巴结百分比、术中或术后并发症发生率或转为开腹手术的百分比方面没有观察到差异。:腹腔镜手术和机器人手术在前哨淋巴结检测率方面没有差异。然而,机器人手术在缩短手术时间和住院时间方面显示出优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b8f/12194557/371daf57d4ff/jcm-14-04013-g001.jpg

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