Technological innovation and personalized surgical treatment for early-stage endometrial cancer patients: A prospective multicenter Italian experience to evaluate the novel percutaneous approach
Technological innovation and personalized surgical treatment for early-stage endometrial cancer patients: A prospective multicenter Italian experience to evaluate the novel percutaneous approach
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DOI：
10.1016/j.ejogrb.2019.01.024
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发表时间：
2019-03-01
影响因子：
2.6
通讯作者：
Rossitto, C.
中科院分区：
文献类型：
--
作者：
Alletti, S. Gueli;Cianci, S.;Rossitto, C.
目的：研究设计：从2015年5月至2017年4月，我们前瞻性地对30例低/中危子宫内膜癌进行了连续的经皮分期（FIGO分期IA GI-G2，IB G1-G2，IA G3）。所有患者被分为两个不同的组的基础上收到的外科手术：A组包括患者提交广泛的A类子宫切除术和双侧输卵管卵巢切除术;组B有关的患者，收到了淋巴结assessmentals.Results：安装经皮器械和耻骨上套管针所需的时间为4分钟。（范围2-10）。A组记录的中位手术时间（OT）为80 min（范围65-120），B组为143 min（范围107-190），其中淋巴结评估的中位时间为55 min（范围20-76）。所有病例中子宫切除术的中位时间为60分钟（范围40-110）。14例（46.6%）进行了淋巴结评估：7例前哨淋巴结定位，7例盆腔淋巴结清扫。未记录术中并发症或LPS/LPT转换。中位出院时间为2天（范围1-4天），5例患者在术后第3天出院，仅1例患者在第4天因发热出院。所有患者均对美容效果表示高度满意。在术后24小时观察到疼痛感知的整体逐渐减少。中位随访时间为14个月（范围12-36），没有复发已检测到。结论：PSS似乎是一种可行的方法，子宫内膜癌分期。更大规模的经验和前瞻性比较研究对于评估我们的假设和进一步研究经皮手术系统的真实的受益非常重要。(C)2019爱思唯尔B. V.保留所有权利。
Objective: To investigate the safety, feasibility and oncological adequacy of the Percutaneous Surgical System- PSS in a consecutive series of low-risk endometrial cancer staging.Study Design: From May 2015 to April 2017, we prospectively performed 30 consecutive percutaneous staging for low/intermediate risk endometrial cancer (FIGO stage IA GI-G2, IB G1-G2, IA G3). All patients were divided in two different groups on the basis of surgical procedure received: Group A included patients submitted to radical Class A hysterectomy and bilateral salpingo-oophorectomy; Group B concerned patients that received a lymph nodal assessment also.Results: The time needed to install percutaneous instruments and suprapubic trocar was 4 min. (range 2-10). The recorded median operative time (0T) was 80 min. (range 65-120) for Gr.A and 143 min. (range 107-190) for Gr.B, in which the median time of lymph nodal assessment was 55 min. (range 20-76). The median time for hysterectomy was 60 min. (range 40-110) in all cases. Lymph nodal assessment was performed in 14 (46.6%) cases: 7 sentinel node mapping, 7 pelvic lymphadenectomy. No intraoperative complications or LPS/LPT conversions were recorded. Median discharge time was 2 days (range 1-4), 5 patients were discharged in 3rd post-op day, and only 1 patient was discharged in 4th day for fever. All patients conveyed high satisfaction with the cosmetic results. A progressive overall reduction of pain perception was observed at 24h after surgery. Median follow-up was of 14 months (range 12-36), no recurrences have been detected.Conclusions: PSS seems to be a feasible approach for endometrial cancer staging. Larger experiences and prospective comparative studies are important to assess our assumptions and further investigate the real benefits of percutaneous surgical system. (C) 2019 Elsevier B.V. All rights reserved.