Objective:This retrospective cohort study compares surgical outcomes among patients with endometrial carcinoma (EC) after the implementation of a robotic-assisted (RA) surgical program at a tertiary care center.Methods:A total of 122 EC patients who underwent surgery between March 2022 and February 2025 were included. Patients were divided into two cohorts based on the implementation of RA surgery: Group 1 (March 2022–August 2023) and Group 2 (September 2023–February 2025). Data collected included demographics, surgical approach, operative time, hospital stay, completion of staging procedures, and 30-day postoperative complications.Results:RA laparoscopy was used predominantly in Group 2, replacing conventional laparoscopy (CL). Laparotomy was significantly less frequent in group 2 (11.9% vs. 36.4%;p< 0.001). Among patients with FIGO stage I, all patients underwent minimally invasive surgery (MIS) in Cohort 2 (100% vs. 71.9%;p< 0.001). Median hospital stay was significantly shorter in Group 2 (3 days vs. 4 days;p< 0.001). A 30-day mortality occurred in one patient (n= 1) within the total study cohort (0.82%) and was attributed to pulmonary embolism on postoperative day 14 after RA laparoscopy. Rates of Grade ≥3 postoperative complications were similar (7.3% vs. 7.5%), as were wound complications (5.5% vs. 3%). The use of sentinel lymph node (SLN) mapping increased significantly in Group 2 (91% vs. 54.5%;p< 0.001). Completion staging procedures were significantly reduced in group 2 (9.1% vs. 0%;p= 0.017).Conclusions:The integration of RA laparoscopy significantly reduced laparotomy rates and hospital stays while increasing SLN mapping. These results support the continued adoption of RA laparoscopy to enhance MIS and improve patient outcomes.
目的：本研究为一项回顾性队列研究，旨在比较某三级医疗中心实施机器人辅助（RA）手术项目后子宫内膜癌（EC）患者的手术结局。 方法：共纳入2022年3月至2025年2月期间接受手术的122例EC患者。根据RA手术的实施时间将患者分为两组：第一组（2022年3月至2023年8月）和第二组（2023年9月至2025年2月）。收集的数据包括人口统计学特征、手术方式、手术时间、住院时间、分期手术完成情况以及术后30天并发症。 结果：第二组主要采用RA腹腔镜手术，替代了传统腹腔镜（CL）手术。第二组开腹手术比例显著降低（11.9% vs. 36.4%；p<0.001）。在FIGO分期为I期的患者中，第二组所有患者均接受了微创手术（MIS）（100% vs. 71.9%；p<0.001）。第二组中位住院时间显著缩短（3天 vs. 4天；p<0.001）。整个研究队列中发生1例术后30天内死亡（0.82%），该患者在RA腹腔镜术后第14天因肺栓塞死亡。两组术后≥3级并发症发生率相近（7.3% vs. 7.5%），伤口并发症发生率也相似（5.5% vs. 3%）。第二组前哨淋巴结（SLN）绘图使用率显著提高（91% vs. 54.5%；p<0.001）。第二组需补充完成分期手术的比例显著降低（9.1% vs. 0%；p=0.017）。 结论：RA腹腔镜手术的整合显著降低了开腹手术率和住院时间，同时提高了SLN绘图使用率。这些结果支持继续推广RA腹腔镜手术以优化微创手术实践并改善患者预后。
Implementation of Robotic-Assisted Surgery for the Treatment of Patients with Endometrial Carcinoma
肿瘤(癌症)患者之家