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Initial experience of robotic anterior pelvic exenteration at a single institute
Authors:Shailesh Puntambekar  Akhil LawandeRiddhi Desai  Seema PuntambekarGeetanjali A. Joshi  Saurabh N. Joshi
Affiliation:Department of Surgical Oncology and Minimal Access Surgery, Galaxy Care Laparoscopy Institute, Pune, India
Abstract:

Objective

To present the initial experience with robotic anterior pelvic exenteration in patients with advanced pelvic cancer at Galaxy Care Laparoscopy Institute, Pune, India.

Methods

A retrospective chart review of data from 10 patients with advanced cervical carcinoma and bladder involvement or with vault recurrence following hysterectomy who were treated at the study hospital between November 2009 and May 2011. Clinicopathologic data and postoperative data including operative time, blood loss, blood transfusions, hospital stay, lymph node yield, and complications were recorded.

Results

The mean operative time was 180 minutes, the mean blood loss was 110 mL, and the mean duration of hospital stay was 5 days. There were no treatment-related morbidities or mortalities. A mean parametrial clearance of 3 cm with a distal vaginal margin of 3.5 cm was achieved. All patients had tumor-free margins. The mean number of harvested lymph nodes was 24. Six patients had positive lymph nodes on pathologic examination and were treated with chemoradiotherapy. At a median follow-up of 11 months, 8 patients were disease-free.

Conclusion

Robot-assisted anterior pelvic exenteration had favorable operative, pathologic, and short-term clinical outcomes. A large multicenter study is required to confirm the results.
Keywords:Minimally invasive exenterative surgery   Pelvic cancer   Pelvic exenteration   Robotics
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