达芬奇机器人辅助宫颈癌根治术中无瘤原则的思考

Tumor-free principles in Da Vinci robot-assisted radical hysterectomy for cervical cancer

宫颈癌是妇科最常见的恶性肿瘤之一。内镜技术的发展,尤其是达芬奇机器人手术系统的推广,推动了宫颈癌微创手术的迅速开展。2018年两项高级别证据研究提示微创手术导致宫颈癌手术不良的肿瘤结局,这在妇科肿瘤界尤其是在中国妇科肿瘤界引发了激烈的争论,无瘤术由此成为研究的焦点。本文结合国内外文献及笔者经验,总结了机器人宫颈癌根治术中贯穿始终的无瘤术相关内容,为微创手术在宫颈癌中合理的应用和改良手术方法提供了方向。

Cervical cancer is one of the most common gynecological malignancies.The development of endoscopic technology,especially the promotion of Da Vinci robotic surgical system,promoting the rapid development of minimally invasive surgery for cervical cancer.In 2018,two important studies published and suggested that the disease free survival(DFS)and Overall survival(OS)of cervical cancer became worse since the minimally invasive surgery applied,which has triggered a fervent discussion in the gynecological oncology community,especially in China,and the tumor-free operation has become the research hotspot.Combined with domestic and foreign literatures and the author’s experience,relevant points of tumor-free principles in robot-assisted radical hysterectomy of cervical cancer were summarized in this paper,aiming to provide references for the correct application and improvement of minimally invasive surgery in cervical cancer.