达芬奇机器人MDT模式全盆腔廓清术治疗晚期宫颈癌一例

Da Vinci robot MDT mode total pelvic exenteration in the treatment of advanced cervical cancer:a case report

目的总结1例达芬奇机器人多学科协作(multi-disciplinary team,MDT)模式全盆腔廓清术治疗晚期宫颈癌的技术体会,探讨该医疗模式在治疗此类疾病的可行性。方法回顾性分析2021年9月解放军总医院第七医学中心妇产医学部1例宫颈鳞状细胞癌ⅣA期患者的临床资料及诊疗过程。结果经MDT模式及术前准备,患者接受机器人全盆腔廓清术(广泛全子宫、双附件切除+腹主动脉旁淋巴结活检+全膀胱、部分尿道、右肾及右输尿管切除+直肠前切除术),手术顺利,围手术期无严重并发症,术后随访半年,恢复良好无复发。结论达芬奇机器人微创手术对部分有指征晚期宫颈癌患者治疗是安全、可行的,能够达到R0切除,采用MDT模式有助于此类患者获益,值得借鉴。

Objective To summarize the technical experience of one case da Vinci robot multi-disciplinary team(MDT)model of total pelvic exenteration for advanced cervical cancer and to explore the feasibility of this medical model in the treatment of such diseases.Methods The clinical data and treatment process of a patient with stageⅣA cervical cancer in the Department of Obstetrics and Gynecology of the PLA General Hospital in Sep.2021 were retrospectively analyzed.Results After MDT consultation and preoperative preparation,the patient underwent robotic total pelvic contouring(extensive total hysterectomy,bilateral adnexal resection+parietal aortic lymph node biopsy+total bladder,partial urethra,right kidney and right ureter resection+anterior rectal resection)with smooth operation and no serious complications in the perioperative period,and good recovery without recurrence in the six-month postoperative follow-up.Conclusions Minimally invasive da Vinci robotic surgery is safe and feasible for the treatment of some patients with indicated advanced cervical cancer,capable of achieving R0 resection,and the use of MDT medical model can help benefit such patients and is worthy of reference.