Intrauterine Manipulator Use During Minimally Invasive Hysterectomy and Risk of Lymphovascular Space Invasion in Endometrial Cancer.
Intrauterine Manipulator Use During Minimally Invasive Hysterectomy and Risk of Lymphovascular Space Invasion in Endometrial Cancer.
复制标题
DOI：
10.1097/igc.0000000000001181
复制
发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Matsuo K
中科院分区：
文献类型：
--
作者：
Machida H;Hom MS;Adams CL;Eckhardt SE;Garcia-Sayre J;Mikami M;Matsuo K
本研究旨在探讨子宫内膜癌患者接受微创子宫切除术时宫内操纵器 (IUM) 使用与淋巴管间隙侵犯 (LVSI) 频率之间的关系。对 2008 年至 2015 年间接受子宫切除术的 I-IV 期子宫内膜癌患者进行了一项回顾性病例对照研究。对病历进行了患者人口统计、手术细节和肿瘤特征的审查。将使用 IUM 进行全腹腔镜子宫切除术 (TLH) 的女性与接受全腹部子宫切除术 (TAH) 的女性进行比较。对存档的医疗记录进行数据收集和倾向评分匹配的审查，以调整 TLH-IUM 和 TAH 组之间的背景差异。通过汇总分析进行系统文献综述来检查 LVSI 的频率。有 687 名女性因子宫内膜癌接受了子宫切除术。其中，419 名女性接受了使用 IUM 的 TLH，194 名女性接受了 TAH。最常见的 IUM 类型是 VCare (89.5%)。两组之间的 LVSI 频率无统计学显着差异：TLH-IUM 组为 15.1%，TAH 组为 19.9%（P = 0.14）。倾向评分匹配后，两组之间的 LVSI 频率相似：TLH-IUM 为 21.2%，TAH 为 19.6%（P = 0.78）。系统文献回顾确定了1371例子宫内膜癌TLH-IUM和1246例TAH，两组间LVSI频率相似（15.0% vs 13.6%，P=0.31）。我们的研究表明，子宫内膜癌 TLH 期间使用 IUM 与 LVSI 频率增加无关。
This study aimed to examine an association between intrauterine manipulator (IUM) use and frequency of lymphovascular space invasion (LVSI) in women with endometrial cancer undergoing minimally invasive hysterectomy. A retrospective case-control study was conducted among stage I–IV endometrial cancer patients who underwent hysterectomy between 2008 and 2015. Medical records were reviewed for patient demographics, surgical details, and tumor characteristics. Women who underwent total laparoscopic hysterectomy (TLH) with IUM use were compared with women who underwent total abdominal hysterectomy (TAH). Review of archived medical record for data collection and propensity score matching were performed to adjust for background differences between TLH-IUM and TAH groups. A systematic literature review with pooled analysis was performed to examine frequency of LVSI. There were 687 women who underwent hysterectomy for endometrial cancer. Of those, 419 women underwent TLH with IUM use and 194 women underwent TAH. The most common type of IUM was VCare (89.5%). There was no statistically significant difference in the frequency of LVSI between the 2 groups: 15.1% for TLH-IUM vs 19.9% for TAH (P = 0.14). After propensity score matching, frequencies of LVSI were similar between the 2 groups: 21.2% for TLH-IUM vs 19.6% for TAH (P = 0.78). Systematic literature review identified 1371 cases of TLH-IUM and 1246 cases of TAH performed for endometrial cancer, and frequencies of LVSI were similar between the 2 groups (15.0% vs 13.6%, P = 0.31). Our study suggests that IUM use during TLH for endometrial cancer is not associated with increased frequency of LVSI.