Safety and feasibility of robotic radical trachelectomy in patients with early-stage cervical cancer
Safety and feasibility of robotic radical trachelectomy in patients with early-stage cervical cancer
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DOI：
10.1016/j.ygyno.2009.10.063
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发表时间：
2010-03-01
影响因子：
4.7
通讯作者：
Soliman, Pamela T.
中科院分区：
文献类型：
--
作者：
Ramirez, Pedro T.;Schmeler, Kathleen M.;Soliman, Pamela T.
objective.本研究旨在确定机器人根治性宫颈切除术和双侧盆腔淋巴结切除术的安全性和可行性。我们还描述了我们的手术技术。这是对2008年10月至2009年5月接受机器人根治性宫颈切除术和双侧盆腔淋巴结切除术的所有患者的回顾性分析。我们分析了我们的数据，以评估该手术的安全性和可行性。该分析包括4例早期宫颈鳞状细胞癌患者。中位体重指数为27.1 kg/m2（范围：22.7 - 39.1）。3例患者为IA2期腺癌; 1例患者为IA1期腺癌伴淋巴管间隙浸润。中位手术时间为339.5 min（范围：245 - 416 min）。中位控制台时间为282.5分钟（范围：217 - 338）。估计失血量中位数为62.5零（范围：50 - 75）。无中转开腹手术。无术中并发症。没有患者需要输血。住院时间中位数为1.5天（范围，1至2天）。1例患者发生术后并发症，一过性左下肢感觉神经病变。无一例患者的宫颈切除标本中有肿瘤残留，无一例患者接受了辅助治疗。切除盆腔淋巴结的中位数为20（范围，18至27）。至成功排尿试验的中位时间为8天（范围，7至9天）。中位随访时间为105天（范围：82 - 217天）。无复发。机器人根治性宫颈切除术和双侧盆腔淋巴结清扫术是可行和安全的，应该考虑为患者希望保留生育力的手术。(C)2009爱思唯尔公司All rights reserved.
Objective. This study aimed to determine the safety and feasibility of robotic radical trachelectomy and bilateral pelvic lymphadenectomy. We also describe Our Surgical technique.Methods. This is a retrospective review of all patients who underwent robotic radical trachelectomy and bilateral pelvic lymphadenectomy from October 2008 to May 2009. We analyzed our data to evaluate the safety and feasibility of this surgery.Results. This analysis included 4 patients with early-stage squamous cell carcinoma of the cervix. The median body mass index was 27.1 kg/m(2) (range, 22.7 to 39.1). Three patients had stage IA2 adenocarcinoma; I patient had stage IA1 adenocarcinoma with lymph-vascular space invasion. The median operative time was 339.5 min (range, 245 to 416). The median console time was 282.5 min (range, 217 to 338). The median estimated blood loss was 62.5 nil (range, 50 to 75). There were no conversions to laparotomy. There were no intraoperative complications. No patient required blood transfusion. The median length of hospital stay was 1.5 days (range, I to 2). One patient experienced a postoperative complication, transient left lower extremity sensory neuropathy. No patient had residual tumor ill the trachelectomy specimen, and no patient underwent adjuvant therapy. The median number of pelvic lymph nodes removed was 20 (range, 18 to 27). The median time to a successful voiding trial was 8 days (range, 7 to 9). The median follow-up was 105 days (range, 82 to 217). There were no recurrences.Conclusion. Robotic radical trachelectomy and bilateral pelvic lymphadenectomy is feasible and safe and should be considered for patients desiring fertility-sparing surgery. (C) 2009 Elsevier Inc. All rights reserved.