切换至 "中华医学电子期刊资源库"

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (04) : 231 -235. doi: 10.3877/cma.j.issn.1674-6899.2019.04.009

所属专题: 机器人手术 文献

论著

机器人早期宫颈癌单中心经验与思考
吕艳红1, 马向东1, 刘淑娟1, 邹伟1, 马佳佳1, 李佳1, 荆茹1, 陈必良1,()   
  1. 1. 771032 西安,空军军医大学西京医院妇产科
  • 收稿日期:2019-07-06 出版日期:2019-08-30
  • 通信作者: 陈必良

Single center experience and consideration of robotic radical hysterectomy for early-stage cervical cancer

Yanhong Lyu1, Xiangdong Ma1, Shujuan Liu1, Wei Zou1, Jiajia Ma1, Jia Li1, Ru Jing1, Biliang Chen1,()   

  1. 1. Department of Obstetrics and Gynecology, Xijing Hospital of Air Force Medical University Shaanxi Xi’an 710032, China
  • Received:2019-07-06 Published:2019-08-30
  • Corresponding author: Biliang Chen
  • About author:
    Corresponding author: Chen Biliang, Email:
引用本文:

吕艳红, 马向东, 刘淑娟, 邹伟, 马佳佳, 李佳, 荆茹, 陈必良. 机器人早期宫颈癌单中心经验与思考[J/OL]. 中华腔镜外科杂志(电子版), 2019, 12(04): 231-235.

Yanhong Lyu, Xiangdong Ma, Shujuan Liu, Wei Zou, Jiajia Ma, Jia Li, Ru Jing, Biliang Chen. Single center experience and consideration of robotic radical hysterectomy for early-stage cervical cancer[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(04): 231-235.

目的

探讨机器人手术治疗早期宫颈癌的安全性及临床结局。

方法

回顾性分析2014年3月至2016年5月空军军医大学西京医院妇产科因早期宫颈癌(宫颈癌IA1期-IB1期)行机器人宫颈癌根治术的患者,统计患者的术后病理情况及治疗情况,以及患者3年及5年的无病生存期(disease-free survival,DFS)和总生存期(overall survival,OS)。

结果

401例患者均完成3年随访。其中,死亡14例,3年OS为96.5%;复发死亡共22例,3年DFS为94.6%。其中,130例患者完成了5年随访,130例患者中死亡8例,5年OS为93.8%;复发死亡共9例,5年DFS为93.1%。

结论

开腹手术无疑是正确的选择,但也不能彻底否定微创手术,包括机器人手术,仍需进一步的临床试验来评估其安全性及临床结局。

Objective

To investigate the safety and clinical outcomes of robotic surgery for early-stage cervical cancer.

Methods

Retrospective analysis of patient with early-stage cervical cancer(IA1-IB1) who were treated with robotic radical hysterectomy in Department of Obstetrics and Gynecology, Xijing Hospital of air force medical university, from Mar. 2014 to May 2016. The postoperative pathological and therapeutic conditions, and disease-free survival(DFS) and overall survive(OS) time of 3 or 5 years were analyzed.

Results

401 patients were followed up for 3 years. Among them, 14 cases died, OS was 96.5% in 3 years, 22 cases died of recurrence, and DFS was 94.6% in 3 years. Among them, 130 patients completed 5-year follow-up. And 8 of the 130 patients died, 5-year OS was 93.8%. A total of 9 patients died of recurrence, and the 5-year DFS was 93.1%.

Conclusions

Open surgery is undoubtedly the right choice, but it cannot completely deny the minimally invasive surgery, including robotic surgery. Further clinical trials are needed to evaluate its safety and clinical outcomes.

表1 早期宫颈癌患者术后辅助治疗情况(%)
表2 患者术后肿瘤复发情况(%)
1
Mettler L, Ibrahim M, Jonat W. One year of experience working with the aid of a robotic assistant the voice-controlled optic holder AESOP (automated endoscopic system for optimal positioning) in gynecological endoscopic surgery[J]. Human Reproduction, 1998, 13(10):2693-2698.
2
郭芳芳,李冬青,齐金红,等.机器人手术与传统腹腔镜宫颈癌根治术的临床比较[J/CD].中华腔镜外科杂志,2016,9(4):224-227.
3
Shazly SA, Murad MH, Dowdy SC, et al. Robotic radical hysterectomy in early stage cervical cancer: a systematic review and meta-analysis[J]. Gynecol Oncol, 2015, 138(2):457-471.
4
Sert BM, Boggess JF, Ahmad S, et al. Robot-assisted versus open radical hysterectomy: a multi-institutional experience for early-stage cervical cancer[J]. Eur J Surg Oncol, 2016, 42(4):513-522.
5
Ramirez PT, Frumovitz M, Pareja R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical Cancer[J]. N Engl J Med, 2018, 379(20):1895-1904.
6
Mendivil AA, Rettenmaier MA, Abaid LN, et al. Survival rate comparisons amongst cervical cancer patients treated with an open, robotic-assisted or laparoscopic radical hysterectomy: a five year experience[J]. Surg Oncol, 2016, 25(1):66-71.
7
Alfonzo E, Wallin E, Ekdahl L, et al. No survival difference between robotic and open radical hysterectomy for women with early-stage cervical cancer: results from a nationwide population-based cohort study[J]. Eur J Cancer, 2019, 116(9):169-177.
8
Shah CA, Beck T, Liao JB, et al. Surgical and oncologic outcomes after robotic radical hysterectomy as compared to open radical hysterectomy in the treatment of early cervical cancer[J]. J Gynecol Oncol, 2017, 28(6):8-8.
9
Siesto G, Finco A, Portuesi RAV, et al. Survival outcomes of robotic radical hysterectomy for early stage cervical cancer: a 9-year study[J]. Int J Med Robot, 2019, 15(4):2003-2003.
10
Melamed A, Margul DJ, Chen L, et al. Survival after minimally invasive radical hysterectomy for early-stage cervical cancer[J]. N Engl J Med, 2018, 379(20):1905-1914.
11
Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. Ca A Cancer Journal for Clinicians, 2015, 65(2):87-87.
12
Lin F, Pan L, Li L, et al. Effects of a simulated CO2 pneumoperitoneum environment on the proliferation, apoptosis, and metastasis of cervical cancer cells in vitro[J]. Med Sci Monit, 2014, 20(12):2497-2503.
13
Kong TW, Chang SJ, Piao X, et al. Patterns of recurrence and survival after abdominal versus laparoscopic/robotic radical hysterectomy in patients with early cervical cancer[J]. J Obstet Gynaecol Res, 2016, 42(1):77-86.
14
Kanao H, Matsuo K, Aoki Y, et al. Feasibility and outcome of total laparoscopic radical hysterectomy with no-look no-touch technique for FIGO IB1 cervical cancer[J]. J Gynecol Oncol, 2019, 30(3):71-71.
15
Sonoda Y, Zerbe M, Smith A, et al. High incidence of positive peritoneal cytology in low-risk endometrial cancer treated by laparoscopically assisted vaginal hysterectomy[J]. Gynecol Oncol, 2001, 80(3):378-382.
16
Lim S, Kim HS, Lee KB, et al. Does the use of a uterine manipulator with an intrauterine balloon in total laparoscopic hysterectomy facilitate tumor cell spillage into the peritoneal cavity in patients with endometrial cancer[J]. Int J Gynecol Cancer, 2008, 18(5):1145-1149.
17
Rakowski JA, Tran TA, Ahmad S, et al. Does a uterine manipulator affect cervical cancer pathology or identification of lymphovascular space involvement [J]. Gynecol Oncol, 2012, 127(1):98-101.
18
McFarland M, Craig E, Lioe TF, et al. Artefactual displacement of cervical epithelium showing CIN III to fallopian tubes during laparoscopic hysterectomy with intrauterine balloon manipulator[J]. Histopathology, 2014, 65(1):139-141.
[1] 国际机器人乳腺外科手术专家协作组(专家委员会). 机器人乳腺癌手术专家共识[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(03): 129-139.
[2] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[3] 丁莹莹, 宋恺, 金姬延, 田华. 机器人辅助膝髋关节置换术后精细化临床护理[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 553-557.
[4] 潘韩丽, 何静, 陈媛媛, 贾梦瑶, 赵兴, 杨佩. 机器人辅助全髋关节置换围手术期应用加速康复护理[J/OL]. 中华关节外科杂志(电子版), 2024, 18(01): 142-146.
[5] 王振宁, 杨康, 王得晨, 邹敏, 归明彬, 王雅楠, 徐明. 机器人与腹腔镜手术联合经自然腔道取标本对中低位直肠癌患者远期疗效比较[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 437-442.
[6] 郭仁凯, 武慧铭, 李辉宇. 机器人辅助全系膜切除术治疗右半结肠癌有效性和安全性的Meta分析及试验序贯分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(03): 234-240.
[7] 嵇晋, 吴胜文, 姜明瑞, 汪刘华, 王伟, 任俊, 王道荣, 马从超. 三种方式关闭盆底联合改良造口在直肠癌腹会阴联合切除术的对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 406-410.
[8] 孙昭, 刘琪, 王殿琛, 姜建武, 符洋. 机器人对比腹腔镜及开放式腹股沟疝修补术的Meta 分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 588-598.
[9] 刘明昊, 李晨, 王冰, 万政, 田文. 机器人与腹腔镜食管裂孔疝修补术对比研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 376-382.
[10] 魏孔源, 仵正, 王铮, 黎韡. 机器人胰腺中段切除后远端胰腺消化道不同重建方式初探[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 295-300.
[11] 曾纪晓, 徐晓钢, 王欣星, 刘斐, 兰梦龙, 陶波圆, 梁子建, 叶志华, 罗媛圆. 达芬奇机器人辅助Swenson-like巨结肠根治术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(04): 239-243.
[12] 王楠, 李立安, 杨雯, 顾成磊, 叶明侠, 李卫平, 张晓莉, 陈琳, 朱晓明, 罗成, 樊杨, 魏淑会, 孟元光. 5G远程机器人妇科手术初步临床实践与评价[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(03): 168-172.
[13] 张可欣, 孙大为, 任常. 国产单孔蛇形臂腹腔镜机器人在妇科领域的应用探索[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(02): 106-110.
[14] 张金珠, 梅世文, 孙金峰, 胡刚, 邱文龙, 李国利, 汪欣, 王锡山, 汤坚强. 原发结直肠癌超系膜切除术后患者的生存危险因素分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(03): 197-204.
[15] 王佳琦, 李兴源, 熊寰, 常泽文, 王子桐, 燕国庆, 丁可, 袁子茗, 乔天宇, 黄睿, 王贵玉, 汤庆超. 机器人手术系统辅助下的结直肠癌经自然腔道取标本手术与常规辅助切口取标本手术的近期疗效对比研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(02): 121-128.
阅读次数
全文


摘要