中国妇幼健康研究2017，Vol.28Issue(5)：498-501,4.DOI:10.3969/j.issn.1673-5293.2017.05.004
机器人宫颈癌根治术用于放化疗后局部晚期宫颈癌的可行性研究
Feasibility study of robot-assisted radical hysterectomy in locally advanced cervical cancer after chemoradiotherapy
摘要
Abstract
Objective To explore the security and feasibility of robot-assisted radical hysterectomy (RRH) in patients with locally advanced cervical cancer (LACC) after chemoradiotherapy.Methods The clinical data of 101 LACC patients stagedⅠB2-ⅡB by International Federation of Gynecology and Obstetrics receiving RRH at Xijing Hospital of Fourth Military Medical University during March 2013 and June 2015 were selected.According to whether treated with preoperative chemoradiotherapy, they were divided into two groups.Totally 51 patients with preoperative chemoradiotherapy were divided into observation group, while 50 patients without receiving any adjuvant therapy before operation were divided into control group.RRH was performed for all patients.The operative time, intraoperative blood loss, postoperative hospital stay, intraoperative and postoperative complications, postoperative pathologic data, postoperative complementary chemoradiotherapy and recurrence survival were analyzed and compared between two groups.The clinical efficacy of preoperative chemoradiotherapy in the observation group was analyzed statistically.Results There was no significant difference in age, BMI, pelvic surgery history and pathological staging between two groups (t value was-0.48 and 0.44, χ2 value was 0.01 and 4.20, respectively, all P>0.05).The number of lymph nodes dissected during operation in the observation group was less than that in the control group, and the difference was statistically significant (Z=-4.04, P<0.001).There was no significant difference in mean operative time, mean intraoperative blood loss, mean postoperative hospital stay, mean postoperative highest temperature of patients, mean postoperative ventilation time and mean postoperative catheter indwelling time (Z value was-1.20,-0.71,-1.40,-0.77,-0.72 and-0.53, respectively, all P>0.05).There was no significant difference in incidence of intraoperative and postoperative complications between two groups (P=0.72*).The total effective rate of preoperative chemoradiotherapy was 76.47% (39/51), including 23.53% in CR rate (12/51) and 52.94% in PR rate (27/51).The positive rates of cervical interstitial infiltration in the observation group and the control group were 29.41% and 94.00%, respectively.The positive rates of lymph node metastasis were 9.80% and 28.00%, respectively.The positive rates of lymphatic vessel infiltration were 1.96% and 14.00%, respectively.The differences were statistically significant (χ2 value was 44.43 and 5.47, respectively, both P<0.05).The number of patients accepting postoperative complementary chemoradiotherapy in the observation group and the control group were 20 and 47, respectively with significant difference (χ2=78.32,P<0.001).During the follow-up period, there were 50 patients survived in the observation group, while in control group there were 47 survived patients.The three-year survival rates of two groups were 98.00% and 92.80%, respectively.The difference was not statistically significant (χ2=1.16, P=0.28).Conclusion RRH in treatment of LACC is safe and feasible.The conclusion still needs a large sample of clinical trials to confirm.关键词
机器人手术/宫颈癌根治术/局部晚期宫颈癌/术前放化疗Key words
robot-assisted surgery/radical hysterectomy/locally advanced cervical cancer (LACC)/preoperative chemoradiotherapy分类
医药卫生引用本文复制引用
马芮,马佳佳,李娜,周福兴,刘海霞,罗天爱,孙小霞,陈必良..机器人宫颈癌根治术用于放化疗后局部晚期宫颈癌的可行性研究[J].中国妇幼健康研究,2017,28(5):498-501,4.基金项目
西京医院临床高新技术基金资助项目(XJGX13LZ04) （XJGX13LZ04）
