对通过应用 Si 级机器人辅助单孔腹腔镜及普通单孔腹腔镜治疗早期子宫内膜癌的临床疗效进行对照分析。方法:回顾性分析因早期子宫内膜癌在上海长征医院实施机器人辅助单孔腹腔镜的 28 例患者及普通单孔腹腔镜下子宫内膜癌分期手术的 32 例患者的临床资料,并结合文献进行分析。结果:所有病例均成功实施单孔机器人辅助单孔腹腔镜和普通单孔腹腔镜下早期子宫内膜癌分期手术,无 1 例另行辅助穿刺孔,无 1 例中转开腹。机器人辅助单孔腹腔镜组手术时间(178.32±17.75)min,普通单孔腹腔镜组手术时间(194.51±23.16)min;机器人辅助单孔腹腔镜组术中出血量(122.96±10.37)ml,普通单孔腹腔镜组术中出血量(147.26±15.19)ml。两组患者术中输血情况及术中脏器损伤无明显差异。结论:Si 级机器人辅助单孔腹腔镜可以完成早期子宫内膜癌分期手术,其手术时间及术中出血情况优于普通单孔腹腔镜下的子宫内膜癌分期手术,两种手术方法均是早期子宫内膜癌的有效手术方法。
To compare the clinical effect of Da Vinci Si robot-assisted single site surgery and laparoendoscopic single site surgery on treating early endometrial carcinoma. Methods: The clinical data of 28 patients with early endometrial cancer who underwent robot-assisted single site surgery(RASS group) and 32 patients underwent laparoendoscopic single site surgery(LESS group) were analyzed retrospectively. Results: All surgeries were successfully completed. No additional puncture hole was made or conversion to laparoseopic surgery occurred. The operation time was 178.32±17.75 minutes (RASS group) Vs 194.51±23.16 minutes (LESS group), the intraoperative bleeding volume was 122.96±10.37 ml (RASS group) Vs 147.26±15.19ml (LESS group). There was no significant difference in blood transfusion and organ injury between the two groups. Conclusion: Da Vinci Si robot-assisted single site surgery could be adopted to treat early endometrial cancer with less operation time and intraoperative bleeding than laparoendoscopic single site surgery. The two approaches are both effective and feasible to treat early endometrial cancer.
收稿日期:2020-03-02 录用日期:2020-05-25
Received Date: 2020-03-02 Accepted Date: 2020-05-25
通讯作者:高京海,Email:gaojinghai@163.com
Corresponding Author: GAO Jinghai, Email: gaojinghai@163.com
引用格式:刘晓军,高京海,王静,等 .Si 级达芬奇机器人辅助单孔腹腔镜与普通单孔腹腔镜在早期子宫内膜癌治疗中的对照研究[J]. 机器人外科学杂志,2020,1(2):108-116.
Citation: LIU X J, GAO J H, WANG J, et al. Comparison between Da Vinci Si robot-assisted and laparoendoscopic single site surgery on treating early endometrial carcinoma[J].Chinese Journal of Robotic Surgery. 2020,1(2):108-116.
[1] Park D A, Lee D H, Kim S W, et al.Comparative safety and effectiveness of robot-assisted laparoscopic hysterectomy versus conventional laparoscopy and laparotomy for endometrial cancer: A systematic review and meta-analysis[J].Eur J Surg Oncol, 2016, 42 (9): 1303-1314.
[2] Fanfani F, Boruta D M, Fader A N, et al.Feasibility and surgical outcome in obese versus nonobese patients undergoing laparoendoscopic single-site hysterectomy: a multicenter case-control study[J].J Minim Invasive Gynecol, 2015, 22 (3): 456-461.
[3] Corrado G, Mereu L, Bogliolo S, et al.Robotic single site staging in endometrial cancer: A multi-institution study[J].Eur J Surg Oncol, 2016, 42 (10): 1506-1511.
[4] Stewart K I, Fader A N.New developments in minimally invasive gynecologic oncology surgery[J].Clin Obstet Gynecol, 2017, 60 (2): 330-348.
[5] 叶慧君 , 江延姣 , 阮芝芳 . 分娩疼痛程度及其相关 因素与分娩结局 [J]. 中华妇产科杂志 , 2011, 46 (10): 753-757.
[6] Chung H, Jang T K, Nam S H, et al.Robotic single-site staging operation for early-stage endometrial cancer: initial experience at a single institution[J]. Obstet Gynecol Sci, 2019, 62 (3): 149-156.
[7] Moukarzel L A, Sinno A K, Fader A N, et al.Comparing Single-Site and Multiport Robotic Hysterectomy with Sentinel Lymph Node Mapping for Endometrial Cancer: Surgical Outcomes and Cost Analysis[J].J Minim Invasive Gynecol, 2017, 24 (6): 977-983.
[8] Corrado G, Calagna G, Cutillo G, et al.The Patient and Observer Scar Assessment Scale to Evaluate the Cosmetic Outcomes of the Robotic Single-Site Hysterectomy in Endometrial Cancer[J].Int J Gynecol Cancer, 2018, 28 (1): 194-199.
[9] Corrado G, Cutillo G, Mancini E, et al.Robotic single site versus robotic multiport hysterectomy in early endometrial cancer: a case control study[J].J Gynecol Oncol, 2016, 27 (4): e39.
[10] Hyewon Chung, Tae-Kyu Jang, Seung Hyub Nam, et al.Robotic single-site staging operation for earlystage endometrial cancer: initial experience at a single institution[J].Obstet Gynecol Sci, 2019, 62 (3): 149- 156.
[11] Bogliolo S, Musacchi V, Cassani C, et al.Robotic Singlesite Technique Allows Pelvic Lymphadenectomy in Surgical Staging of Endometrial Cancer[J].J Minim Invasive Gynecol, 2015, 22 (4): 695-696.
[12] Iavazzo C, Minis E E, Gkegkes I D.Single-site port robotic-assisted hysterectomy: an update[J].J Robot Surg, 2018, 12 (2): 201-213.
[13] Vizza E, Chiofalo B, Cutillo G, et al.Robotic single site radical hysterectomy plus pelvic lymphadenectomy in gynecological cancers[J].J Gynecol Oncol, 2018, 29 (1): e2.
[14] Yoon A, Yoo H N, Lee Y Y, et al.Robotic single-port hysterectomy, adnexectomy, and lymphadenectomy in endometrial cancer[J].J Minim Invasive Gynecol, 2015, 22 (3): 322.
[15] Sinno A K, Fader A N, Tanner E J 3rd.Single site robotic sentinel lymph node biopsy and hysterectomy in endometrial cancer[J].Gynecol Oncol, 2015, 137 (1): 190.
[16] Gallotta V, Giudice M T, Conte C, et al.Minimally invasive salvage lymphadenectomy in gynecological cancer patients: A single institution series[J].Eur J Surg Oncol, 2018, 44 (10): 1568-1572.
[17] Jeong I G, Khandwala Y S, Kim J H, et al.Association of robot-ic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015[J].JAMA, 2017, 318: 1561-1568.
[18] Moukarzel L A, Fader A N, Tanner E J.Feasibility of Robotic-Assisted Laparoendoscopic Single-Site Surgery in the Gynecologic Oncology Setting[J].J Minim Invasive Gynecol, 2017, 24 (2): 258-263.
[19] Barraez D, Godoy H, McElrath T, et al. Low incidence of port-site metastasis after robotic assisted surgery for endometrial cancer staging: descriptive analysis[J]. J Robot Surg, 2015, 9 (1): 91-95.