BACKGROUND Cervical cancer is the most common gynecological malignancy,ranking first in female reproductive malignancies with more than 500000 new cases and 275000 deaths each year.Traditionally,open radical hysterect...BACKGROUND Cervical cancer is the most common gynecological malignancy,ranking first in female reproductive malignancies with more than 500000 new cases and 275000 deaths each year.Traditionally,open radical hysterectomy is considered the standard surgical procedure for the treatment of resectable cervical cancer.The latest guidelines from the National Comprehensive Cancer Network and the European Society of Gynecological Oncology suggest that open surgery and laparoscopic surgery(using traditional laparoscopic or robotic techniques)are the main surgical approaches for radical hysterectomy for patients with stage IA2-IIA cervical cancer.Robotic surgery has been increasingly used in abdominal surgery and has shown more beneficial effects.AIM To analyse the perioperative conditions,complications,and short-term and longterm effects in patients undergoing robotic radical hysterectomy(RRH)and laparoscopic radical hysterectomy(LRH)to compare their clinical efficacy,safety,and feasibility.METHODS The perioperative data of patients undergoing RRH and LRH were extracted and collected from the database of surgical treatments for cervical cancer for statistical analysis.RESULTS Of the patients,342 underwent LRH for cervical cancer,and 216 underwent RRH.The total complication rate was 9.65%(20 patients)in the RRH group and 17.59%(60 patients)in the LRH group.The complication rate was significantly lower in the RRH group than in the LRH group.There was no significant difference in the follow-up period(P=0.658).The total recurrence rates were 15.7%and 12%in the RRH and LRH groups,respectively.The progression-free survival time was 28.91±15.68 mo and 28.34±15.13 mo in the RRH and LRH groups,respectively(P=0.669).The overall survival(OS)rates were 92.13%and 94.45%in the RRH and LRH groups,respectively(P=0.292).The OS time was 29.87±15.92 mo and 29.41±15.14 mo in the RRH and LRH groups,respectively(P=0.732).The survival curves and the progression-free survival curves were not statistically significantly different between the two groups(P=0.407 and 0.28,respectively).CONCLUSION RRH is associated with significantly less operative time and blood loss than LRH.The two procedures have similar complication rates,OS,and progression-free survival time.展开更多
In the last 10 years,surgery has been developing towards minimal invasiveness;therefore,robotic surgery represents the consequent evolution of laparoscopic surgery.Worldwide,surgeons’performances have been upgraded b...In the last 10 years,surgery has been developing towards minimal invasiveness;therefore,robotic surgery represents the consequent evolution of laparoscopic surgery.Worldwide,surgeons’performances have been upgraded by the ergonomic developments of robotic systems,leading to several benefits for patients.The introduction into the market of the new Da Vinci Xi system has made it possible to perform all types of surgery on the colon,an in selected cases,to combine interventions in other organs or viscera at the same time.Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection.From this perspective,single-port robotic colectomy,has reduced the number of robotic ports needed,allowing a better anesthetic outcome and faster recovery.The introduction on the market of new surgical robotic systems from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes.展开更多
目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术...目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术(腹腔镜组).比较两组患者手术情况、术后恢复情况及术后并发症.结果:机器人组手术时间明显长于腹腔镜组(161.1 min±41.4 min vs 135.5 min±39.1m i n,P=0.001),术中出血量少于腹腔镜组(104.8 m L±70.8 m L vs 140.3 m L±81.4 m L,P=0.013),低位直肠癌的保肛率高于腹腔镜组[65.0%(13/20)vs 25.0%(4/16),P=0.017],排气时间、进流质时间、拔尿管时间均短于腹腔镜组(P<0.05),但住院费用明显高于腹腔镜组(2.7万元±1.1万元vs 4.3万元±1.3万元,P=0.000).两组手术均无中转开腹.两组在标本切除长度、肿瘤下缘距下切缘的长度、淋巴结清扫数目、术后住院时间和术后并发症发生率方面比较差异无统计意义(P>0.05).结论:达芬奇机器人直肠癌根治术取得与腹腔镜手术相同的根治效果,并具有创伤小、术中出血少、术后恢复快、保肛率高等优势,可作为治疗直肠癌的有效手段之一.展开更多
文摘BACKGROUND Cervical cancer is the most common gynecological malignancy,ranking first in female reproductive malignancies with more than 500000 new cases and 275000 deaths each year.Traditionally,open radical hysterectomy is considered the standard surgical procedure for the treatment of resectable cervical cancer.The latest guidelines from the National Comprehensive Cancer Network and the European Society of Gynecological Oncology suggest that open surgery and laparoscopic surgery(using traditional laparoscopic or robotic techniques)are the main surgical approaches for radical hysterectomy for patients with stage IA2-IIA cervical cancer.Robotic surgery has been increasingly used in abdominal surgery and has shown more beneficial effects.AIM To analyse the perioperative conditions,complications,and short-term and longterm effects in patients undergoing robotic radical hysterectomy(RRH)and laparoscopic radical hysterectomy(LRH)to compare their clinical efficacy,safety,and feasibility.METHODS The perioperative data of patients undergoing RRH and LRH were extracted and collected from the database of surgical treatments for cervical cancer for statistical analysis.RESULTS Of the patients,342 underwent LRH for cervical cancer,and 216 underwent RRH.The total complication rate was 9.65%(20 patients)in the RRH group and 17.59%(60 patients)in the LRH group.The complication rate was significantly lower in the RRH group than in the LRH group.There was no significant difference in the follow-up period(P=0.658).The total recurrence rates were 15.7%and 12%in the RRH and LRH groups,respectively.The progression-free survival time was 28.91±15.68 mo and 28.34±15.13 mo in the RRH and LRH groups,respectively(P=0.669).The overall survival(OS)rates were 92.13%and 94.45%in the RRH and LRH groups,respectively(P=0.292).The OS time was 29.87±15.92 mo and 29.41±15.14 mo in the RRH and LRH groups,respectively(P=0.732).The survival curves and the progression-free survival curves were not statistically significantly different between the two groups(P=0.407 and 0.28,respectively).CONCLUSION RRH is associated with significantly less operative time and blood loss than LRH.The two procedures have similar complication rates,OS,and progression-free survival time.
文摘In the last 10 years,surgery has been developing towards minimal invasiveness;therefore,robotic surgery represents the consequent evolution of laparoscopic surgery.Worldwide,surgeons’performances have been upgraded by the ergonomic developments of robotic systems,leading to several benefits for patients.The introduction into the market of the new Da Vinci Xi system has made it possible to perform all types of surgery on the colon,an in selected cases,to combine interventions in other organs or viscera at the same time.Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection.From this perspective,single-port robotic colectomy,has reduced the number of robotic ports needed,allowing a better anesthetic outcome and faster recovery.The introduction on the market of new surgical robotic systems from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes.
文摘目的:比较达芬奇机器人与腹腔镜直肠癌根治术的近期疗效.方法:回顾分析2014-12/2016-01在南昌大学第一附属医院行直肠癌根治术120例患者的临床资料,其中运用达芬奇机器人手术系统行直肠癌根治术63例(机器人组),57例行腹腔镜直肠癌根治术(腹腔镜组).比较两组患者手术情况、术后恢复情况及术后并发症.结果:机器人组手术时间明显长于腹腔镜组(161.1 min±41.4 min vs 135.5 min±39.1m i n,P=0.001),术中出血量少于腹腔镜组(104.8 m L±70.8 m L vs 140.3 m L±81.4 m L,P=0.013),低位直肠癌的保肛率高于腹腔镜组[65.0%(13/20)vs 25.0%(4/16),P=0.017],排气时间、进流质时间、拔尿管时间均短于腹腔镜组(P<0.05),但住院费用明显高于腹腔镜组(2.7万元±1.1万元vs 4.3万元±1.3万元,P=0.000).两组手术均无中转开腹.两组在标本切除长度、肿瘤下缘距下切缘的长度、淋巴结清扫数目、术后住院时间和术后并发症发生率方面比较差异无统计意义(P>0.05).结论:达芬奇机器人直肠癌根治术取得与腹腔镜手术相同的根治效果,并具有创伤小、术中出血少、术后恢复快、保肛率高等优势,可作为治疗直肠癌的有效手段之一.
