This single-institution, retrospective study aimed to compare the surgical outcomes of single-port, multi-port, and robot-assisted laparoscopy, as well as laparotomy, in patients with endometrial cancer who underwent surgical staging between January 2006 and December 2017. This study evaluated various parameters, including disease-free survival (DFS), overall survival (OS), recurrence rate (RR), recurrence site, and intra- and postoperative complications. Propensity score matching was performed to account for baseline characteristics, and a total of 881 patients were included in the analysis. The 3-year DFS of single-port laparoscopy was similar to that of the other groups, but laparotomy exhibited a lower 3-year DFS compared to multi-port (p= 0.001) and robot-assisted (p= 0.031) laparoscopy. Single-port laparoscopy resulted in a significantly higher 3-year OS than laparotomy (p= 0.013). After propensity score matching, the four groups demonstrated similar survival outcomes (3-year DFS:p= 0.533; 3-year OS:p= 0.328) and recurrence rates (10.3%, 12.1%, 10.3%, and 15.9% in the single-port, multi-port, and robot-assisted laparoscopy and laparotomy groups, respectively,p= 0.552). Recurrence most commonly occurred in distant organs. The single-port laparoscopy group had the longest operative time (205.1 ± 76.9 min) but the least blood loss (69.5 ± 90.8 mL) and the shortest postoperative hospital stay (5.2 ± 2.3 days). In contrast, the laparotomy group had the shortest operative time (163.4 ± 51.0 min) but the highest blood loss (368.3 ± 326.4 mL) and the longest postoperative hospital stay (10.3 ± 4.6 days). The transfusion rate was 0% in the single-port laparoscopy group and 3.7% in the laparotomy group. Notably, the laparotomy group had the highest wound complication rate (p= 0.001), whereas no wound hernias were observed in the three minimally invasive approaches. In conclusion, the survival outcomes were comparable between the methods, with the benefit of lower blood loss and shorter hospital stay observed in the single-port laparoscopy group. This study suggests that single-port laparoscopy is a feasible approach for endometrial cancer surgical staging.
这项单中心回顾性研究旨在比较2006年1月至2017年12月期间接受手术分期的子宫内膜癌患者中，单孔腹腔镜、多孔腹腔镜、机器人辅助腹腔镜以及开腹手术的手术效果。研究评估了包括无病生存期（DFS）、总生存期（OS）、复发率（RR）、复发部位以及术中和术后并发症在内的多项参数。为平衡基线特征，研究进行了倾向性评分匹配，共纳入881例患者进行分析。单孔腹腔镜的3年DFS与其他组相似，但开腹手术的3年DFS低于多孔腹腔镜（p=0.001）和机器人辅助腹腔镜（p=0.031）。单孔腹腔镜的3年OS显著高于开腹手术（p=0.013）。倾向性评分匹配后，四组患者显示出相似的生存结果（3年DFS：p=0.533；3年OS：p=0.328）和复发率（单孔腹腔镜组、多孔腹腔镜组、机器人辅助腹腔镜组和开腹手术组的复发率分别为10.3%、12.1%、10.3%和15.9%，p=0.552）。复发最常见于远处器官。单孔腹腔镜组手术时间最长（205.1±76.9分钟），但失血量最少（69.5±90.8毫升），术后住院时间最短（5.2±2.3天）。相比之下，开腹手术组手术时间最短（163.4±51.0分钟），但失血量最多（368.3±326.4毫升），术后住院时间最长（10.3±4.6天）。单孔腹腔镜组的输血率为0%，开腹手术组为3.7%。值得注意的是，开腹手术组的伤口并发症发生率最高（p=0.001），而三种微创手术方式均未观察到伤口疝。总之，各种手术方法的生存结果相当，其中单孔腹腔镜组具有失血量更少和住院时间更短的优势。本研究提示，单孔腹腔镜是子宫内膜癌手术分期的一种可行方法。
肿瘤(癌症)患者之家