robotic assisted, total laparoscopic, and total abdominal hysterectomy for management of uterine cancer机器人辅助、总腹腔镜腹全子宫子宫癌的管理.pdf

Journal of Cancer Therapy, 2012, 3, 162-166 /10.4236/jct.2012.32022 Published Online April 2012 (http://www.SciRP.org/journal/jct) Robotic Assisted, Total Laparoscopic, and Total Abdominal Hysterectomy for Management of Uterine Cancer 1 1 1,2 1,2 1 1 Nevadunsky Nicole , Clark Rachel , Muto Michael , Berkowitz Ross , Ghosh Sue , Vitonis Allison , Feltmate Colleen1,2 1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA; 2Gillette Center for Women’s Cancer, Dana-Farber Harvard Cancer Center, Boston, USA. Email: nnevadun@ Received February 28, 2012; revised March 29, 2012; accepted April 16, 2012 ABSTRACT Objectives: The purpose was to compare robotic assisted total laparoscopic hysterectomy (TRH), laparoscopic assisted hysterectomy (TLH) and total abdominal hysterectomy (TAH) with surgical staging +/− lymphadenectomy for the management of uterine cancer. Methods: Institutional review board approval was obtained and patient characteristics, pathologic data, and data related to the surgical procedure were collected from chart review. Data were analyzed with SAS statistical software. Results: A total of 102 TRHs were compared to 115 TLHs and 79 TAHs. There were more grade I and endometrial intraepithelial (EIN) lesions in the preoperative pathology of TLHs (P 0.01). Pelvic lym- phadenectomy was performed in 71 (70%) TRH, 46 (58%) TAH, and 28 (24%) TLH cases (P 0.01). Mean surgical time was 203, 133 and 132 minutes for TRHs, TLHs, and TAHs (P 0.05). Estimated blood loss was 69, 86, and 215 ml for TRH, TLH, and TAH (P 0.05). Blood transfusions were 19% in TAHs versus 3% and 2% in TLHs and TRHs (P 0.01). There were fewer wound infections (2% vs. 10%) in TRHs versus