Abstract：
BACKGROUND: Exenteration surgery for multi-visceral pelvic malignancy is a complex life-changing operation with high perioperative morbidity and mortality. Traditional open surgery has long been the standard approach for pelvic exenteration for achieving Ro resection which is the main aim of surgery. In the current era of minimally invasive surgery, robotic-assisted pelvic exenteration has provided a promising alternative, offering potential advantages in terms of improved oncological outcomes and enhanced postoperative recovery. This study aims to explore the feasibility of a robotic platform for locally advanced multi-visceral pelvic malignancy.
METHODS: A retrospective review from the prospectively maintained robotic colorectal surgery database at University Hospital Coventry and Warwickshire (UHCW) Trust was performed. Demographic details and clinical and surgical details were documented from the case records. Data was analysed using SPSS version 22.
RESULTS: Thirteen female patients diagnosed with primary or recurrent pelvic malignancy who underwent robotic pelvic exenteration at UHCW between February 2019 and April 2023 at UHCW were included. The mean age of our patients was 60.4 (± 10.1) years. Complete Ro resection was achieved in all 13 (100%) cases on final histopathology. The median length of hospital stay was 15 days after this extensive surgery. Grade 3 morbidity on Clavien-Dindo classification was observed in four (30.7%) patients, while zero percent 30-day mortality was experienced in this study. At a median follow-up of 21 (3-53) months, we observed tumor recurrence in three (23.7%) patients, while death in four (30.7%) patients. Only few studies have highlighted outcomes of robotic pelvic exenteration, and our results were quite comparable to them.
CONCLUSIONS: Robotic-assisted pelvic exenteration for primary or recurrent pelvic malignancy is feasible with improved oncological and acceptable postoperative outcomes.
METHODS: A retrospective review from the prospectively maintained robotic colorectal surgery database at University Hospital Coventry and Warwickshire (UHCW) Trust was performed. Demographic details and clinical and surgical details were documented from the case records. Data was analysed using SPSS version 22.
RESULTS: Thirteen female patients diagnosed with primary or recurrent pelvic malignancy who underwent robotic pelvic exenteration at UHCW between February 2019 and April 2023 at UHCW were included. The mean age of our patients was 60.4 (± 10.1) years. Complete Ro resection was achieved in all 13 (100%) cases on final histopathology. The median length of hospital stay was 15 days after this extensive surgery. Grade 3 morbidity on Clavien-Dindo classification was observed in four (30.7%) patients, while zero percent 30-day mortality was experienced in this study. At a median follow-up of 21 (3-53) months, we observed tumor recurrence in three (23.7%) patients, while death in four (30.7%) patients. Only few studies have highlighted outcomes of robotic pelvic exenteration, and our results were quite comparable to them.
CONCLUSIONS: Robotic-assisted pelvic exenteration for primary or recurrent pelvic malignancy is feasible with improved oncological and acceptable postoperative outcomes.
摘要：
背景：盆腔多脏器恶性肿瘤的手术是一项复杂的改变生活的手术，围手术期发病率和死亡率都很高。传统的开放手术长期以来一直是盆腔切除术的标准方法，以实现Ro切除，这是手术的主要目的。在当前的微创手术时代,机器人辅助盆腔炎提供了一个有希望的替代方案，在改善肿瘤预后和增强术后恢复方面提供潜在优势.本研究旨在探讨机器人平台治疗局部晚期多内脏盆腔恶性肿瘤的可行性。
方法：对考文垂和沃里克郡大学医院（UHCW）信托基金前瞻性维护的机器人结直肠手术数据库进行了回顾性回顾。从病例记录中记录人口统计学细节以及临床和手术细节。使用SPSS版本22分析数据。
结果：纳入了在2019年2月至2023年4月期间在UHCW接受机器人盆腔切除术的13例诊断为原发性或复发性盆腔恶性肿瘤的女性患者。我们患者的平均年龄为60.4（±10.1）岁。在最终的组织病理学上，所有13例（100％）都实现了Ro完全切除。该广泛手术后的中位住院时间为15天。Clavien-Dindo分类的3级发病率在4例（30.7％）患者中观察到，而在这项研究中，30天死亡率为零。在中位随访21(3-53)个月时，我们观察到3例（23.7％）患者的肿瘤复发，4例（30.7%）患者死亡。只有少数研究强调了机器人盆腔切除术的结果，我们的结果与他们相当。
结论：机器人辅助盆腔切除术治疗原发性或复发性盆腔恶性肿瘤是可行的，可改善肿瘤学和可接受的术后结局。
方法：对考文垂和沃里克郡大学医院（UHCW）信托基金前瞻性维护的机器人结直肠手术数据库进行了回顾性回顾。从病例记录中记录人口统计学细节以及临床和手术细节。使用SPSS版本22分析数据。
结果：纳入了在2019年2月至2023年4月期间在UHCW接受机器人盆腔切除术的13例诊断为原发性或复发性盆腔恶性肿瘤的女性患者。我们患者的平均年龄为60.4（±10.1）岁。在最终的组织病理学上，所有13例（100％）都实现了Ro完全切除。该广泛手术后的中位住院时间为15天。Clavien-Dindo分类的3级发病率在4例（30.7％）患者中观察到，而在这项研究中，30天死亡率为零。在中位随访21(3-53)个月时，我们观察到3例（23.7％）患者的肿瘤复发，4例（30.7%）患者死亡。只有少数研究强调了机器人盆腔切除术的结果，我们的结果与他们相当。
结论：机器人辅助盆腔切除术治疗原发性或复发性盆腔恶性肿瘤是可行的，可改善肿瘤学和可接受的术后结局。
