机器人辅助前哨淋巴结活检治疗早期宫颈癌的临床疗效评价

Clinical evaluation of robot-assisted sentinel lymph node biopsy in the treatment of early cervical cancer

目的比较达芬奇机器人辅助前哨淋巴结活检在早期宫颈癌根治术中的安全性及优势。方法回顾性分析盐城市第一人民医院2021年12月—2023年1月47例宫颈癌IA1[淋巴脉管间隙浸润(lymph-vascular space Invasion,LVSI)阳性]~IB1期住院患者分别接受机器人辅助前哨淋巴结活检(sentinel lymph node biopsy,SLNB)宫颈癌根治术(机器人SLNB组,n=20)与机器人系统性盆腔淋巴结清扫(pelvic lymph node dissection,PLND)宫颈癌根治术(机器人PLND组,n=27)的相关临床资料。结果机器人SLNB组手术时间、术中出血量、术后并发症、术后住院时间、盆腔引流管保留时间等均少于机器人PLND组,两组以上各指标比较差异均有统计学意义(P<0.05)。结论机器人SLNB较机器人PLND在宫颈癌根治术中是安全可行的,其能够显著减少手术时间、术中出血量、减少住院时间、减少盆腔引流管放置时间及术后并发症。机器人辅助前哨淋巴结切除手术作为一种创新的手术方式,需要大样本临床研究证实。

Objective To compare the safety and advantage of Da Vinci robot assisted sentinel lymph node excision in radical operation of early cervical cancer.Method A retrospective analysis was conducted on 47 inpatients with cervical cancer(A1[LVSI]~IB1)in Yancheng First People's Hospital from December 2021 to January 2023,of whom 20 received robot-assisted sentinel lymph node radical resection for cervical cancer(robotic SLNB group,n=20)and 27 received robotic systemic pelvic lymph node dissection radical cervicectomy(robotic PLND group,n=27).Results The operative time,intraoperative blood loss,postoperative complications,postoperative hospital stay and pelvic drainage retention time of the robot SLNB group were all lower than those of the robot PLND group,and the differences of the above indexes were statistically significant(P<0.05).Conclusion Compared with the robotic PLND group,the robotic SLNB group is safe and feasible in cervical cancer radical resection,which can significantly reduce the operation time,intraoperative blood loss,hospital stay,pelvic drainage placement time and postoperative complications.As an innovative surgical method,robot-assisted sentinel lymph node biopsy needs to be certified in a large sample clinical study.