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Abstract：
Background: Patients with persistent or recurrent cervical cancer, following primary treatment with concurrent chemoradiation, represent a subgroup eligible for pelvic exenteration. In light of the substantial morbidity associated with open pelvic exenterations, minimally invasive surgical techniques have been introduced. This systematic review aims to analyze and discuss the current literature on robotic-assisted pelvic exenterations in cervical cancer. In addition, novel aspects of compartment-based magnetic resonance imaging (MRI) are highlighted. Methods: This systematic review followed the PRISMA guidelines, and a comprehensive literature search on robotic-assisted pelvic exenterations in cervical cancer was conducted to assess, as main objectives, early and late postoperative complications as well as oncological outcomes. Inclusion and exclusion criteria were applied to select eligible studies. Results: Among the reported cases of robotic-assisted pelvic exenterations in cervical cancer, 79.4% are anterior pelvic exenterations. Intraoperative complications are minimal and early/late major complications averaged between 30-35%, which is lower compared to open pelvic exenterations. Oncological outcomes are similar between robotic and open pelvic exenterations. Sensitivity for locoregional invasion increases up to 93% for compartment-based MRI in colorectal cancer. A refined delineation of the seven pelvic compartments for cervical cancer is proposed here. Conclusions: Robotic-assisted pelvic exenterations have demonstrated feasibility and safety, with reduced rates of major complications compared to open surgery, while maintaining surgical efficiency and oncological outcomes. Compartment-based MRI holds promise for standardizing the selection and categorization of pelvic exenteration procedures.
摘要：
背景：患有持续性或复发性宫颈癌的患者，在同步放化疗的主要治疗之后，代表符合盆腔切除术的亚组。鉴于与开放性盆腔切除术相关的大量发病率，已经引入了微创手术技术。本系统综述旨在分析和讨论机器人辅助盆腔切除术在宫颈癌中的最新文献。此外,基于隔室的磁共振成像（MRI）的新颖方面被强调。方法：本系统综述遵循PRISMA指南，并对机器人辅助的宫颈癌盆腔切除术进行了全面的文献检索，作为主要目标，术后早期和晚期并发症以及肿瘤预后。纳入和排除标准用于选择符合条件的研究。结果：在报告的宫颈癌机器人辅助盆腔切除术病例中，79.4%为前盆腔切除术。术中并发症很少，早期/晚期主要并发症平均在30-35％之间。与开放性盆腔切除术相比更低。机器人和开放式盆腔切除术之间的肿瘤结果相似。在结直肠癌中，基于室的MRI对局部侵袭的敏感性增加高达93％。这里提出了宫颈癌的七个盆腔隔室的精细轮廓。结论：机器人辅助盆腔切除术具有可行性和安全性。与开放手术相比，主要并发症的发生率降低，同时保持手术效率和肿瘤结果。基于隔室的MRI有望标准化盆腔切除术的选择和分类。
