Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer: A Single-Institution Retrospective Cohort Study
Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer: A Single-Institution Retrospective Cohort Study
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DOI：
10.1016/j.jmig.2015.11.006
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发表时间：
2016-03-01
影响因子：
4.1
通讯作者：
Scambia, Giovanni
中科院分区：
文献类型：
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作者：
Alletti, Salvatore Gueli;Rossitto, Cristiano;Scambia, Giovanni
研究目的：比较使用Telelap ALF-X平台与传统腹腔镜手术治疗早期子宫内膜癌患者的手术和临床结局。设计：单机构回顾性队列研究（加拿大工作组分类II-2）。单位：妇产科，妇科肿瘤科，天主教圣心大学，罗马，意大利。患者：该研究涉及89名受早期子宫内膜癌影响的患者，他们在2013年10月至2014年9月期间接受了择期手术分期。其中，43例（48.3%）进行了Telelap ALF-X分期（ALF-X组），46例（51.7%）进行了传统的腹腔镜分期（腹腔镜组）。干预措施：所有选定的患者进行了腹腔镜分期广泛子宫切除术（A级sec Querleu-Morrow），双侧输卵管卵巢切除术，盆腔淋巴结清扫术，如果需要。2个手术组进一步分为不需要盆腔淋巴结切除术的患者（亚组1）和接受盆腔淋巴结切除术的患者（亚组2）。测量和主要结果：在ALF-X组中，亚组1的中位手术时间为128分钟（范围，69-260分钟），亚组2为193分钟（范围，129-290分钟）。在腹腔镜组中，亚组1的中位手术时间为82分钟（范围，25-180分钟），亚组2为104分钟（范围，36-160分钟）。ALF-X组和腹腔镜组的手术时间差异具有统计学意义（p = 0.000）。在ALF-X组的亚组1中，有1例转为标准腹腔镜手术（2.3%），2例转为剖腹手术（4.7%）（p = 0.234）。腹腔镜组无中转开腹手术。术后并发盆腔血肿1例ALF-X组亚组1例（2.3%），1例亚闭塞，1例肺水肿结论：根据手术结果和并发症发生率，我们的结果表明Telelap ALF-X入路用于子宫内膜癌分期是可行和安全的;然而，需要进一步的研究来明确评估Telelap ALF-X在早期子宫内膜癌分期中的作用。(C)2016年AAGL。All rights reserved.
Study Objective: To compare the surgical and clinical outcomes of patients affected by early-stage endometrial cancer treated using the Telelap ALF-X platform versus conventional laparoscopic surgery.Design: Single institution retrospective cohort study (Canadian Task Force classification II-2).Setting: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.Patients: The study involved 89 patients affected by early-stage endometrial cancer who underwent elective surgical staging between October 2013 and September 2014. Among them, 43 (48.3%) underwent Telelap ALF-X staging (ALF-X group), and 46 (51.7%) underwent conventional laparoscopic staging (laparoscopic group).Interventions: All selected patients underwent laparoscopic staging with radical hysterectomy (class A sec Querleu-Morrow), bilateral salpingo-oophorectomy, and pelvic lymphadenectomy if required. The 2 surgical groups were further divided into patients who did not require pelvic lymphadenectomy (subgroup 1) and those who underwent pelvic lymphadenectomy (subgroup 2).Measurements and Main Results: In the ALF-X group, the median operative time was 128 minutes (range, 69-260 minutes) for subgroup 1 and 193 minutes (range, 129-290 minutes) for subgroup 2. In the laparoscopic group, the median operative time was 82 minutes (range, 25-180 minutes) in subgroup 1 and 104 minutes (range, 36-160 minutes) in subgroup 2. The difference in operative time between subgroups was statistically significant in both the ALF-X and laparoscopic groups (p = .000). In subgroup 1 of the ALF-X group, there was 1 conversion to standard laparoscopy (2.3%) and 2 conversions to laparotomy (4.7%) (p = .234). No conversions to laparotomy occurred in the laparoscopic group. Postoperative complications included 1 case of pelvic hematoma (2.3%) in subgroup 1 of the ALF-X group and 1 case of subocclusion and 1 case of pulmonary edema (4.3%) in subgroup 1 of the laparoscopic group.Conclusion: Based on operative outcomes and complication rates, our results suggest that the Telelap ALF-X approach is feasible and safe for endometrial cancer staging; however, further studies are needed to definitively assess the role of Telelap ALF-X early-stage endometrial cancer staging. (C) 2016 AAGL. All rights reserved.