机器人子宫切除术治疗III类肥胖的子宫内膜癌:来自英国吉尔福德中心的13年经验

IF 2.1 3区 医学 Q2 SURGERY
Konstantinos Palaiologos, Nana-Oye Bosompra, Alkim Arikan, Radwa Hablase, Anil Tailor, Hersha Patel, Patricia Ellis, Jayanta Chatterjee, Simon Butler-Manuel
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引用次数: 0

摘要

背景:病态肥胖患者的手术治疗在技术上具有挑战性;然而,这可以通过机器人手术来缓解。我们报告了13年来机器人子宫切除术治疗iii类肥胖(BMI≥40 kg/m)和子宫内膜癌患者的经验。材料和方法本回顾性队列研究纳入了2010年至2023年间因子宫内膜癌接受机器人子宫切除术的236名iii类肥胖妇女。主要结局包括完成率和围手术期事件。比较分析评估了技术升级、前哨淋巴结评估的引入和外科医生的学习曲线后的结果。统计分析对分类变量使用Fisher精确检验和卡方检验,对连续变量使用ANOVA和Kruskall-Wallis检验。结果机器人子宫切除术成活率为91.5%(216/236),转剖腹手术成活率为2.5%(6/236)。中位住院时间为1天。感染发生率为6.9%(15/216)。剖腹手术发生率从2010-2015年的11%(9/236)下降到2020-2023年的0% (p = 0.004),具有统计学意义。结论机器人子宫切除术可以安全地完成大多数病态肥胖子宫内膜癌患者的围手术期并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Robotic Hysterectomy for Endometrial Cancer in Class III Obesity: 13 Years of Experience From a UK Epicentre in Guildford

Background

Surgery in morbidly obese patients is technically challenging; however, this can be mitigated using robotic surgery. We present 13-years’ experience of robotic hysterectomy in patients with Class-III obesity (BMI≥ 40 kg/m) and endometrial cancer.

Materials and Methods

This retrospective cohort study included 236 women with Class-III obesity who underwent robotic hysterectomy for endometrial cancer between 2010 and 2023. Key outcomes include, completion rates and peri-operative events. Comparative analysis evaluated outcomes following technological upgrades, introduction of sentinel lymph-node assessment and surgeons' learning curve. Statistical analysis used Fisher's exact test and Chi-squared for categorical variables, and ANOVA and Kruskall-Wallis tests for continuous variables.

Results

Robotic hysterectomy was completed in 91.5% (216/236), with conversion to laparotomy in 2.5% (6/236). Median inpatient admission was 1 day. Infection occurred in 6.9% (15/216). A statistically significant decrease in laparotomies from 11% (9/236) (2010–2015) to 0% (2020–2023) (p = 0.004) was observed.

Conclusion

Robotic Hysterectomy can be safely completed in majority of morbidly obese patients with endometrial cancer with minimal perioperative complications.

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来源期刊
CiteScore
4.50
自引率
12.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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