晚期卵巢癌的微创细胞减少手术:一个非选择的连续系列机器人辅助病例

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Journal of Clinical Obstetrics and Gynecology Pub Date : 2023-04-28 DOI:10.29328/journal.cjog.1001126
Shammas Natalie, Avila Rosa, Khatchadourian Christopher, Spencer-Smith Erland Laurence, Stern Lisa, Vasilev Steven
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引用次数: 0

摘要

晚期卵巢癌手术的金标准需要通过中线垂直剖腹探查。研究表明,微创手术(MIS)是一种安全有效的早期卵巢癌手术治疗方法。在某些情况下,MIS也可以选择性地用于晚期卵巢癌的细胞减少手术。机器人平台有可能在晚期复杂手术中提供与开腹手术相似的结果,同时加速恢复,最小化发病率,减少围手术期并发症。本研究的主要目的是评估接受机器人辅助细胞减少术的晚期卵巢癌患者的手术和围手术期预后。对2017年7月1日至2021年12月31日期间接受手术治疗的所有晚期卵巢癌患者的非选择性连续系列进行了图表回顾。在此期间,所有被诊断为III期至IV期卵巢癌的患者都在洛杉矶的两家城市社区教学医院接受了机器人辅助的细胞减少手术。25例患者被确定并纳入本研究。所有手术均由一名外科医生完成。96%的患者(25例中有24例)达到了最佳或完全的CRS。7例(28%)进行了原发性细胞减少(PCRS), 18例(72%)进行了间歇细胞减少(ICRS)。估计中位失血量为100 mL (25 ~ 500 mL),中位手术时间为5.9小时(3.1 ~ 10.5小时),开腹转复率为0%。术中无并发症,肠梗阻30天内再入院率为4%(1例),采用保守治疗。目前,该病例系列中有64%的患者仍然存活。中位生存期尚未达到。中位随访时间为4.08年。从这个非选择的,连续的病例系列中提出的结果说明了微创机器人方法如何可以安全地取代标准的剖腹探查卵巢细胞减少术。
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Minimally invasive cytoreductive surgery in advanced ovarian cancer: A nonselected consecutive series of robotic-assisted cases
The gold standard for advanced-stage ovarian cancer surgery entails exploration via a midline vertical laparotomy. Studies have shown that minimally invasive surgery (MIS) can be a safe and effective method for the surgical management of early ovarian cancer. In some cases, MIS can also be selectively used for cytoreductive surgery in cases with advanced-stage ovarian cancer. The robotic platform has the potential to provide similar outcomes to the laparotomy-based standard of care in advanced complex surgery while accelerating recovery, minimizing morbidity, and reducing perioperative complications. The primary objective of this study was to evaluate surgical and perioperative outcomes in patients with advanced ovarian carcinoma who underwent robotic-assisted cytoreduction. A chart review of a nonselected consecutive series of all patients undergoing surgical management of advanced ovarian cancer between 7/1/2017 and 12/31/2021 was conducted. All patients that were diagnosed with Stage III to IV ovarian cancer between the timeframe underwent robotic-assisted cytoreductive surgery at two urban community teaching hospitals in Los Angeles. Twenty-five patients were identified and included in this study. All surgeries were performed by a single surgeon. Optimal or complete CRS was achieved in 96% of the patients (24 of 25 cases). Seven (28%) underwent primary cytoreduction (PCRS) and 18 (72%) underwent interval cytoreduction (ICRS). The estimated median blood loss was 100 mL (25-500 mL), the median operative time was 5.9 hours (3.1-10.5 hours), and the conversion rate to open laparotomy was 0%. There were no intraoperative complications and the readmission rate within 30 days was 4% (1 patient) for ileus, which was managed conservatively. Currently, 64% of the patients in the case series remain alive. The median survival has not been reached. The median follow-up is 4.08 years. Results presented from this nonselected, consecutive case series illustrate how a minimally invasive robotic approach can be safely used in place of the standard exploratory laparotomy for ovarian cytoreduction.
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来源期刊
Journal of Clinical Obstetrics and Gynecology
Journal of Clinical Obstetrics and Gynecology Medicine-Obstetrics and Gynecology
CiteScore
0.30
自引率
0.00%
发文量
8
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