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101.
Background
Cervical cancer represents one of the most common types of neoplasia among women; the use of minimally invasive techniques in the treatment of cervical cancer is a challenge.Objectives
To present evidence regarding robotic technology in the performance of pelvic exenteration in cases of cervical cancer.Search strategy
PubMed and Scopus databases were searched.Selection criteria
Articles examining the use of robotic technology for pelvic exenteration in cases of cervical cancer were included.Data collection and analysis
Four studies were included.Main results
Most cancers treated with robotic-assisted pelvic exenteration were squamous cell carcinomas of the cervix. The stage of primary cancer ranged from IB2 to IVA. In 7 of the 8 patients, anterior pelvic exenteration was performed; the other patient underwent total pelvic exenteration. Procedure duration ranged from 375 to 600 minutes; blood loss was 200–550 mL. Postoperative complications occurred in 2 of the 8 patients and included perineal abscess, Miami pouch fistula, and ureteral stenosis. Postoperative hospital stay ranged from 3 to 53 days, and postoperative follow-up ranged from 2 to 31 months.Conclusions
The gold standard for pelvic exenteration remains the open surgical approach; however, the application of robotic technology could be an alternate choice associated with excellent results. 相似文献102.
Briony K. Varda Patricia Cho Andrew A. Wagner Richard S. Lee 《Journal of pediatric urology》2018,14(2):182.e1-182.e8
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目的 评估机器人辅助行椎弓根螺钉置钉的准确性并观察置钉并发症。方法 回顾性分析2014年12月—2015年5月苏州大学附属第一医院骨科行机器人辅助椎弓根螺钉置入的13例患者临床资料。其中男6例,女7例;年龄41~73岁,平均56.5岁;L1爆裂性骨折2例,L2压缩性骨折1例,L4滑脱症4例,T12爆裂性骨折伴截瘫1例,L1陈旧性压缩性骨折伴后凸畸形1例,退行性侧弯1例,先天性脊柱侧弯术后翻修1例,腰椎间盘突出症伴椎管狭窄症1例,脊髓灰质炎后遗症性脊柱侧弯1例。采用Gertzbein和Robbins标准,CT定量分析椎弓根螺钉位置,并记录置钉所致并发症如神经根、血管、脊髓损伤等。结果 由机器人辅助置钉成功12例,其中83枚螺钉由机器人成功辅助置入,1枚螺钉因术中机器人无法注册改为徒手置钉;另1例患者因术中发现机器人置钉的进针点偏差大,改为徒手置钉。根据Gertzbein和Robbins标准,A级80枚,B级2枚,C级1枚,置钉准确率达98.8%(82/83)。无置钉所致并发症如神经根、脊髓损伤及血管损伤等。结论 机器人辅助椎弓根螺钉置钉精准性高,可减少或避免置钉所致并发症。 相似文献
105.
Y.C. Ou C.K. Yang J. Wang S.W. Hung C.L. Cheng A.K. Tewari V.R. Patel 《European journal of surgical oncology》2013
Background
To analyze the trifecta outcome (continence, potency, and cancer control) in 300 cases of robotic-assisted laparoscopic radical prostatectomy (RARP).Methods
A prospective assessment of outcomes in 300 consecutive patients that underwent a RARP performed by a single surgeon. Patients were grouped according to D'Amico risk criteria: Group I consisted of ‘low-risk’ cases (n = 64), Group II consisted of ‘intermediate-risk’ cases (n = 88), and Group III consisted of ‘high-risk’ cases (n = 148). Patients were evaluated for perioperative complications and the trifecta outcome.Results
The operation time, blood loss, post-operative stay, duration of urethral catheterization, and perioperative complication rate were similar among all groups. The incidence of bilateral neurovascular bundle (NVB) preservation was significantly decreased with the increasing risk of cases (P < 0.001). The continence rates at the 1-week, 1-month, 3-month, 6-month, and 12-month follow-ups did not differ significantly between groups. The potency rates at the 12-month follow-up were not significantly different. The positive surgical margin and positive lymph node metastasis rate increased with the increasing risk of cases (P < 0.001). The biochemical recurrence rate (BCR, PSA >0.2 ng/mL) was 3.1, 11.36, and 19.59% in Groups I, II and III, respectively (P = 0.004). The trifecta outcome for RARP with bilateral NVB preservation showed no significant differences among groups.Conclusions
Undergoing a RARP is safe and feasible in high-risk prostate cancer patients. Compared to low-risk and intermediate-risk groups, the high-risk group had a significant higher incidence of positive surgical margin, positive lymph node metastasis, and BCR rate. 相似文献106.
A. Masson-Lecomte D.R. Yates K. Bensalah C. Vaessen A. de la Taille M. Roumiguié N. Doumerc F. Bruyère L. Soustelle S. Droupy M. Rouprêt 《European journal of surgical oncology》2013
Objective
To assess operative and pathological results obtained after robot-assisted partial nephrectomy (RAPN) in renal masses over 4 cm.Patients and methods
Between 2007 and 2011, 220 robotic nephron-sparing surgeries (NSS) were performed at six French urology departments. Data were prospectively collected: age, BMI, pre and post-operative eGFR (MDRD), operative time (OT), warm ischemia time (WIT), estimated blood loss (EBL), length of hospital stay (LOS), Clavien complications, pathological results and oncologic outcome. Tumor complexity was assessed according to the RENAL nephrometry score.Results
Overall, 54 tumors were included. Median follow up was 26 months. Median age at surgery was 62 years. Median RENAL nephrometry score was 7 (4–10). Median WIT was 23 min (10–59). Median OT and EBL were 180 min (110–425) and 100 cc (0–2500). Blood transfusion occurred in 7 cases (13%). Median tumor size was 45 mm (40–70). Three patients had positive surgical margins. Median LOS was 5 days (2–28). Nine patients presented post-operative complications of which 1/3 were considered as major (Clavien IIIb). Median pre-operative and post-operative eGFR was 88 (36–136) and 75 ml/min (33–122) (p = 0.01), respectively. Two patients developed subsequent metastasis. The 2-year progression free survival (PFS) rate was 90.5%.Conclusion
Our results confirm that RAPN is a useful and acceptable approach for renal masses greater than 4 cm in size. When technically possible, NSS provides promising short-term cancer-specific survival rates with acceptable morbidity. Tumor size is not sufficiently discriminant enough and RENAL nephrometry score should increasingly used to describe tumor complexity. 相似文献107.
Pedro T. Ramirez Alpa M. Nick Michael Frumovitz Kathleen M. Schmeler 《Journal of minimally invasive gynecology》2013,20(6):766-769
The rate of venous thromboembolic events (VTEs) including deep venous thrombosis and pulmonary embolism among women undergoing gynecologic surgery is high, particularly for women with a gynecologic malignancy. Current guidelines recommend VTE thrombopropylaxis in the immediate postoperative period for patients undergoing open surgery. However, the VTE prophylaxis recommendations for women undergoing minimally invasive gynecologic surgery are not as well established. The risk of VTEs in patients undergoing minimally invasive surgery appears to be low based on retrospective analyses. To date, there are no established guidelines that specifically provide a standard of care for patients undergoing minimally invasive gynecologic surgery for benign or malignant disease. 相似文献
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