Feasibility and perioperative outcomes of percutaneous-assisted laparoscopic hysterectomy: A multicentric Italian experience
Feasibility and perioperative outcomes of percutaneous-assisted laparoscopic hysterectomy: A multicentric Italian experience
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DOI：
10.1016/j.ejogrb.2019.12.020
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发表时间：
2020-02-01
影响因子：
2.6
通讯作者：
Rossitto, Cristiano
中科院分区：
文献类型：
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作者：
Alletti, Salvatore Gueli;Perrone, Emanuele;Rossitto, Cristiano
目的：这项多中心前瞻性II期研究旨在研究经皮辅助腹腔镜子宫切除术在围手术期结局、可行性、VAS评分和美容结局方面的可行性、安全性和有效性。在2015年5月至2017年10月期间，382名患者被认为有资格使用Percuvancel（TM）进行微创经皮辅助腹腔镜子宫切除术，经皮手术系统- PSS，TELEFLEX ltd.，其中80例患者（20.9%）符合入选标准并入组本研究，协调中心为Fondazione Policlinico Universitario A妇科肿瘤科。Gemelli IRCCS，罗马，意大利。入选患者接受经皮辅助腹腔镜全子宫切除术+/-双侧输卵管卵巢切除术+/-淋巴结评估。结果：中位年龄为52岁（范围，32-80），中位体重指数为25 kg/m2（范围，16-37）。35例患者（43.8%）既往接受过手术。登记的中位手术时间为82.5（范围，40-190）分钟，中位估计失血量为50（50-500）mL。我们观察到1例（1.3%）术中并发症。至出院的中位时间为1（范围，1-5）天。患者对疤痕评估和术后疼痛控制非常满意。术后30 d内发生并发症5例（6.25%）。结论：经皮辅助筋膜外子宫切除术在可行性、安全性和有效性方面取得了良好的效果，即使在复杂病例和先进的手术操作中也是如此。因此，该技术似乎平衡了最小手术侵入性和标准入路有效性的局限性和优势。(C)2020 Elsevier B. V.保留所有权利。
Objective: This multicentric prospective phase II study aimed to investigate the feasibility, safety, and efficacy of percutaneous-assisted laparoscopic hysterectomy in terms of perioperative outcomes, feasibility, VAS score, and cosmetic outcomes.Study Design: Between May 2015 and October 2017, 382 patients were considered eligible for minimally invasive percutaneous-assisted laparoscopic hysterectomy using Percuvancel (TM), Percutaneous Surgical System - PSS, TELEFLEX ltd. Among them, 80 patients (20.9 %) met the inclusion criteria and were enrolled in the study.The coordinator center was the Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Enrolled patients underwent total percutaneous-assisted laparoscopic hysterectomy +/- bilateral salpingo-oophorectomy +/- nodal assessment.Results: The median age was 52 (range, 32-80) years, and the median body mass index was 25 kg/m(2) (range, 16-37). Thirty-five patients (43.8 %) had previous surgery. A median operative time of 82.5 (range, 40-190) minutes and a median estimated blood loss of 50 (50-500) mL were registered. We observed 1 (1.3 %) intraoperative complication. The median time to discharge was 1 (range, 1-5) day. Patients were extremely satisfied with the scar evaluation and postoperative pain control. Five (6.25 %) complications were recorded within 30 days after surgery.Conclusion: Percutaneous-assisted technique for extrafascial hysterectomy achieved excellent results in terms of feasibility, safety, and efficacy, even in complex cases and advanced surgical procedures. Therefore, the technique appears to balance the limitations and advantages of minimal surgical invasiveness and standard approach efficacy. (C) 2020 Elsevier B.V. All rights reserved.