摘要
目的:通过总结单中心机器人手术治疗中央型复发宫颈癌病例资料，探讨该疗法的临床应用价值。方法:选取2014年9月至2022年12月期间在解放军总医院第一医学中心诊断并接受机器人手术治疗的19例中央型复发宫颈癌病例作为研究对象，回顾性分析病例特点、机器人手术相关情况、随访资料，讨论并分享相关经验。结果:19例患者平均年龄47.53±7.33岁，平均体质量指数(body mass index，BMI)22.54±2.56 kg/m2，鳞癌17例、腺癌2例，平均复发间隔18.84±12.55个月，先期化疗5例，手术完成R0切除18例，发生严重并发症2例。其中接受盆腔廓清术(pelvic exenteration，PE)13例，与非PE手术组比较，PE手术组的先期化疗比例更高，手术时间更长、多学科协作比例更高，平均住院时间更长(P<0.05)。所有患者平均随访时间42.11±30.54个月，中位随访时间为25个月，1年期、2年期总生存率(overall survival，OS)分别为89.47%、68.42%。结论:对于中央型复发宫颈癌，机器人手术是一种合理的治疗选择，应充分评估病情，合理把握手术指征，发挥机器人手术和多学科协作的优势，同时重视利用综合治疗的各种手段，改善患者预后。
Abstract
Objective:To investigate the clinical application value of robotic surgery in the treatment of central recurrent cervical cancer in a single center.Methods:A total of 19 cases of central recurrent cervical cancer diagnosed and treated by robotic surgery in the First Medical Center of PLA General Hospital from Sep. 2014 to Dec. 2022 were selected as the research objects. The characteristics of the cases, the relevant situation of robotic surgery, and follow-up data were retrospectively analyzed. In addition, the diagnosis and treatment experience were discussed and shared.Results:The average age of the 19 patients was 47.53±7.33 years, the average BMI was 22.54±2.56 kg/m2, there were 17 cases of squamous cell carcinoma and 2 cases of adenocarcinoma. The mean recurrence interval was 18.84±12.55 months, 5 cases of neoadjuvant chemotherapy, 18 cases of surgical R0 resection, and 2 cases of serious complications. Among them, 13 patients received pelvic exenteration(PE). Compared with the non-PE surgery group, the PE surgery group reported a higher proportion of neoadjuvant chemotherapy, a longer operation time, a higher proportion of multidisciplinary collaboration, and a longer mean hospital stay (P<0.05). The mean follow-up time of all patients was 42.11±30.54 months, and the median follow-up time was 25 months. The 1-year and 2-year overall survival were 89.47% and 68.42%, respectively.Conclusion:For central recurrent cervical cancer, robotic surgery is a reasonable treatment option. The condition should be fully evaluated, surgical indications should be strict, the advantages of robotic surgery and multidisciplinary collaboration should be brought into play, and various means of comprehensive treatment should be emphasized to improve the prognosis of patients.
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