Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.301
Filtrar
1.
Yonsei Med J ; 62(1): 68-74, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33381936

RESUMO

PURPOSE: There is lack of data on direct comparison of survival outcomes between open surgery and robot-assisted staging surgery (RSS) using three robotic arms for endometrial cancer. The purpose of this study was to compare the overall survival (OS) and disease-free survival (DFS) between open surgery and RSS using three robotic arms for endometrial cancer. MATERIALS AND METHODS: Consecutive women with endometrial cancer who underwent surgery between May 2006 and May 2018 were identified. Robotic procedures were performed using the da Vinci robotic system, and the robotic approach consisted of three robotic arms including a camera arm. Propensity score matching, as well as univariate and multivariate Cox regression of OS and DFS were performed according to clinicopathologic data and surgical method. RESULTS: The study cohort included 423 unselected patients with endometrial cancer, of whom 218 underwent open surgery and 205 underwent RSS using three robotic arms. Propensity score-matched cohorts of 146 women in each surgical group showed no significant differences in survival: 5-year OS of 91% vs. 92% and DFS of 86% vs. 89% in the open and robotic cohorts, respectively (hazard ratio, 1.02; 95% confidence interval, 0.82-1.67). In the univariate analysis with OS as the endpoint, surgical method, age, stage, type II histology, grade, and lymph node metastasis were independently associated with survival. Surgical stage, grade, and type II histology were found to be significant independent predictors for OS in the multivariate analysis. CONCLUSION: RSS using three robotic arms and laparotomy for endometrial carcinoma had comparable survival outcomes.


Assuntos
Neoplasias do Endométrio/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Adulto , Idoso , Estudos de Coortes , Intervalo Livre de Doença , Neoplasias do Endométrio/patologia , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pontuação de Propensão , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/instrumentação
2.
Urol Clin North Am ; 48(1): 1-9, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218583

RESUMO

Robot-assisted radical prostatectomy (RARP) is the most common surgical treatment of localized prostate cancer. The ideal procedure would achieve maximum oncological efficacy while minimizing associated side effects, such as erectile dysfunction and urinary incontinence. Surgeon experience and surgical technique affect RARP outcomes. Here, the authors review RARP technical modifications aimed at optimizing cancer control and postoperative urinary and sexual function.


Assuntos
Prostatectomia/métodos , Prostatectomia/normas , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/normas , Humanos , Masculino , Complicações Pós-Operatórias/prevenção & controle , Próstata/cirurgia , Prostatectomia/efeitos adversos , Procedimentos Cirúrgicos Robóticos/efeitos adversos
3.
Urol Clin North Am ; 48(1): 103-112, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218584

RESUMO

Lower urinary tract reconstruction has traditionally been approached in an open fashion but select complications or disease processes may be suitable for robotic reconstruction, including bladder neck contractures, proximal urethral strictures, and genitourinary fistulas. Here, the authors discuss the novel techniques used and the feasibility of robotic reconstruction for these conditions. The robotic approach is relatively novel, and more data and studies will be required to make definitive statements regarding success rate and complications from the procedure. Preliminary data suggest that the robotic approach may offer comparable success compared with open techniques.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Uretra/cirurgia , Doenças Uretrais/cirurgia , Doenças da Bexiga Urinária/cirurgia , Bexiga Urinária/cirurgia , Humanos , Obstrução Uretral/cirurgia , Fístula Urinária/cirurgia
4.
Urol Clin North Am ; 48(1): 11-23, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218585

RESUMO

Radical prostatectomy has undergone many adaptations since its inception, including the Retzius-sparing robotic-assisted radical prostatectomy approach. In this article, we review the origins of radical prostatectomy, the theoretic basis for Retzius-sparing robotic-assisted radical prostatectomy, and outline the key steps of the procedure. To date, there have been 9 studies comparing the outcomes of Retzius-sparing robotic-assisted radical prostatectomy with standard robotic-assisted radical prostatectomy, which have demonstrated improved continence outcomes for Retzius sparing robotic assisted radical prostatectomy within the first year and equivalent oncologic efficacy out to 18 months. Further research is needed to evaluate sexual function outcomes as well as long-term oncologic outcomes.


Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Fáscia , Fasciotomia , Previsões , História do Século XX , História do Século XXI , Humanos , Masculino , Próstata/cirurgia , Prostatectomia/efeitos adversos , Prostatectomia/história , Prostatectomia/tendências , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/história , Procedimentos Cirúrgicos Robóticos/tendências , Incontinência Urinária/etiologia , Incontinência Urinária/prevenção & controle
5.
Urol Clin North Am ; 48(1): 113-125, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218586

RESUMO

Almost 30 years have passed since the inception of minimally invasive surgery in urology and specifically in pediatric urology. Laparoscopy has now become an essential tool in the pediatric urologic armamentarium. The application of robot-assisted surgery in pediatrics has allowed for widespread utilization for common reconstructive procedures such as pyeloplasty and ureteral reimplantation. Understanding the implementation, technical considerations, and outcomes are critical for continued success and adoption. This has allowed for increased use in more complex urologic procedures such as redo pyeloplasty, dismembered ureteral reimplantation, catheterizable channel creation, and bladder augmentation.


Assuntos
Pelve Renal/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Ureter/cirurgia , Doenças Urológicas/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Anestesia , Criança , Previsões , Humanos , Curva de Aprendizado , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Reconstrutivos/tendências , Reimplante , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/tendências , Obstrução Ureteral/cirurgia , Doenças Urológicas/congênito , Procedimentos Cirúrgicos Urológicos/tendências , Refluxo Vesicoureteral/cirurgia
6.
Urol Clin North Am ; 48(1): 127-135, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218587

RESUMO

The robotic platform offers theoretical and practical advantages to microsurgical male infertility surgery. These include reduction or elimination of tremor, 3-dimensional visualization, and decreased need for skilled surgical assistance. This article reviews the application of robotic surgery to each of the 4 primary male infertility procedures: vasectomy reversal, varicocelectomy, testicular sperm extraction, and spermatic cord denervation. Historical perspective is presented alongside the available outcomes data, which are limited in most cases. Before the robotic approach can be widely adopted, further clinical trials are needed to compare outcomes and costs with those of other validated surgical techniques.


Assuntos
Infertilidade Masculina/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Vasovasostomia/métodos , Azoospermia/cirurgia , Denervação/métodos , Previsões , Humanos , Infertilidade Masculina/etiologia , Masculino , Microcirurgia/métodos , Microcirurgia/tendências , Procedimentos Cirúrgicos Robóticos/tendências , Cordão Espermático/inervação , Cordão Espermático/cirurgia , Testículo/cirurgia , Varicocele/cirurgia , Vasovasostomia/tendências
7.
Urol Clin North Am ; 48(1): 147-150, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218589

RESUMO

"The new frontier of robotic surgery is well under way. Current research and development is rapidly progressing, allowing for the creation of many new robotic companies. Each company has its own identity and platform for what their vision for the future entails. The competition generated between these companies will shortly be forcing newer, cheaper, more accessible robotic systems worldwide."


Assuntos
Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Urológicos/instrumentação , Inteligência Artificial/tendências , Previsões , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/tendências , Robótica/instrumentação , Robótica/tendências , Procedimentos Cirúrgicos Urológicos/métodos , Procedimentos Cirúrgicos Urológicos/tendências
8.
Urol Clin North Am ; 48(1): 25-33, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218591

RESUMO

"Approximately 1 million prostate biopsies are performed each year in the United States. This procedure has traditionally been performed using a transrectal approach, which is associated with a significant risk of infectious complications including sepsis. In recent years, transperineal prostate biopsy has been increasingly adopted due to its lower associated infectious risk. In this review, we explore the benefits of the transperineal approach for performing prostate biopsy and detail technical advancements that have allowed for this procedure to now be routinely performed in the outpatient settings under local anesthesia."


Assuntos
Biópsia/métodos , Biópsia Guiada por Imagem/métodos , Próstata/patologia , Neoplasias da Próstata/patologia , Infecções Bacterianas/etiologia , Infecções Bacterianas/prevenção & controle , Biópsia/efeitos adversos , Biópsia/tendências , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/tendências , Imagem por Ressonância Magnética , Masculino , Períneo/cirurgia , Próstata/cirurgia , Neoplasias da Próstata/cirurgia , Reto/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/tendências , Ultrassonografia
9.
Urol Clin North Am ; 48(1): 45-50, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218593

RESUMO

"The robotic approach for radical cystectomy has become increasingly adopted by the urologic oncology community, as it has been shown to have equivalent oncologic outcomes with shorter hospital stay and fewer perioperative transfusions. Consensus guidelines from expert surgeons have been published to provide guidance on all aspects of how to implement the robotic approach in the urologic oncology clinic."


Assuntos
Cistectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Bexiga Urinária/cirurgia , Bexiga Urinária/cirurgia , Cistectomia/tendências , Humanos , Seleção de Pacientes , Assistência Perioperatória , Procedimentos Cirúrgicos Robóticos/tendências
10.
Urol Clin North Am ; 48(1): 51-70, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218594

RESUMO

Robotic-assisted radical cystectomy has gained increasing popularity over the past decade. Initially, the procedure was performed with extracorporeal urinary diversion given the technical challenges of the intracorporeal approach. Since then, innovative techniques have been described to facilitate bowel manipulation, assess ureteral and mesenteric vasculature, and perform ureteroenteric and urethro-ileal anastomosis. Overcoming the learning curve associated with intracorporeal urinary diversion can lead to decreased blood loss, shorter operative times, and faster convalescence, particularly with enhanced recovery protocols. Herein we review technical points, complications, outcomes, and future innovations in intracorporeal urinary diversion."


Assuntos
Cistectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Bexiga Urinária/cirurgia , Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Cistectomia/estatística & dados numéricos , Recuperação Pós-Cirúrgica Melhorada , Previsões , Humanos , Curva de Aprendizado , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Derivação Urinária/estatística & dados numéricos , Derivação Urinária/tendências
11.
Urol Clin North Am ; 48(1): 71-80, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218595

RESUMO

Upper tract urothelial carcinoma is a rare malignancy for which surgery provides definitive management. Open radical nephroureterectomy was the gold standard treatment, but laparoscopic and robot-assisted approaches are alternative options. Kidney-sparing approaches are feasible for carefully selected patients with ureteral cancer. This article discusses the evaluation of patients with upper tract urothelial carcinoma and definitive management using robot-assisted surgical approaches. Patients with urothelial carcinoma of the upper tract can be treated with robot-assisted nephroureterectomy, distal ureterectomy, and segmental ureterectomy.


Assuntos
Carcinoma de Células de Transição/cirurgia , Neoplasias Renais/cirurgia , Nefroureterectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Ureterais/cirurgia , Anastomose Cirúrgica , Humanos , Reimplante/métodos , Ureter/cirurgia , Neoplasias Urológicas/cirurgia
12.
Urol Clin North Am ; 48(1): 81-90, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218596

RESUMO

Surgical techniques for robot-assisted partial nephrectomy are driven by the aims of simplifying the most challenging surgical steps, maximizing functional and oncologic outcomes, and consistently pushing the envelope on possibilities. Over the past several years, we have seen an emergence in not only innovation in surgical technique, and robotic platforms, but integration of a variety of imaging techniques. We believe with developing robotic expertise, practicing urologists will continue to push the envelope in nephron preservation and complication-free recovery.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Rim/cirurgia , Nefrectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Carcinoma de Células Renais/diagnóstico por imagem , Meios de Contraste , Humanos , Processamento de Imagem Assistida por Computador , Raios Infravermelhos , Rim/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Laparoscopia , Nefrectomia/tendências , Procedimentos Cirúrgicos Robóticos/tendências , Cirurgia Assistida por Computador , Ultrassonografia/métodos
13.
Urol Clin North Am ; 48(1): 91-101, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218597

RESUMO

Robotically assisted laparoscopic techniques may be used for proximal and distal ureteral strictures. Distal strictures may be approached with ureteroneocystotomy, psoas hitch, and Boari flap. Ureteroureterostomy, buccal mucosa graft ureteroplasty, and appendiceal flap ureteroplasty are viable techniques for strictures anywhere along the ureter. Ileal ureteral substitution is reserved for more extensive disease, and autotransplantation is reserved for salvage situations.


Assuntos
Constrição Patológica/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Algoritmos , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Árvores de Decisões , Humanos , Íleo/transplante , Mucosa Bucal/transplante , Assistência Perioperatória , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Reimplante , Retalhos Cirúrgicos , Ureter/anatomia & histologia , Ureter/irrigação sanguínea , Obstrução Ureteral/diagnóstico , Obstrução Ureteral/etiologia , Procedimentos Cirúrgicos Urológicos/instrumentação
14.
Rev Med Suisse ; 16(717): 2339-2342, 2020 Dec 02.
Artigo em Francês | MEDLINE | ID: mdl-33263959

RESUMO

Radical cystectomy with urinary diversion is the surgical treatment of invasive bladder cancer. Functional impairment is another indication. Robotic technique slowly started 15 years ago but its benefit remains questionable. We present the results of around thirty patients who underwent robotic cystectomy (RC) between 2016 and 2019 and were compared to an open cystectomy (OC) group. While this series is finishing its implementation phase, the results show that RC is equivalent to OC in terms of oncologic control as well as for the overall complication rate. Moreover, blood loss and the hospital length of stay are inferior for RC patients. These results participate to the actual trend towards putative further validation of RC.


Assuntos
Cistectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Padrão de Cuidado , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Humanos , Resultado do Tratamento
15.
Chirurgia (Bucur) ; 115(5): 656-664, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33138903

RESUMO

Introduction: ganglioneuromas are benign tumors emerging from the sympathetic nervous system that could grow up to significant sizes before becoming symptomatic. Aim: to describe the surgical technique of the posterior microscopic and anterior robotic assisted staged approach for voluminous "dumbbell" ganglioneuroma. Besides this, a detailed report of the evolution of 9 years old female patient with such a tumor who underwent a staged bipolar approach, under direct neuromonitoring is presented. The literature has been reviewed on this topic. Methods: the neurosurgical approach consisted in S2-S3 laminectomy, resecting the intracanalar and intraforaminal S2 tumor, ligating and sectioning the S2 root, the surgical approach was minimally invasive using the DaVinci XI platform for excising the anterior retrorectal extension. Results: As for the posterior surgical stage, the neurosurgical operating time was 165 minutes with a five days hospital stay, and the second anterior surgical staged step took 660 minutes with five days hospital stay. There were no complications in both surgical stages, and the postoperative outcome was uneventful. The 6 months MRI evidenced no recurrency. Conclusions: the posterior microscopic and anterior robotic-assisted staged approach with continuous neuromonitoring for "dumbbell" ganglioneuroma has proven to be an efficient surgical strategy and technique. Further studies may support the effectiveness of this novel surgical approach and strategy.


Assuntos
Ganglioneuroma , Microcirurgia/métodos , Neoplasias do Sistema Nervoso Periférico/cirurgia , Procedimentos Cirúrgicos Robóticos , Raízes Nervosas Espinhais/cirurgia , Criança , Feminino , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/cirurgia , Humanos , Laminectomia , Imagem por Ressonância Magnética , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Procedimentos Cirúrgicos Robóticos/métodos , Raízes Nervosas Espinhais/diagnóstico por imagem , Resultado do Tratamento
17.
Dis Colon Rectum ; 63(9): 1334-1337, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33216503

RESUMO

INTRODUCTION: As multidisciplinary treatment modalities for rectal cancer continue to evolve, neoadjuvant chemoradiation then surgical resection is a common approach. Robotic-assisted abdominoperineal resection is becoming more prevalent in part because of better visualization and instrument mobility within the pelvis. After abdominoperineal resection, postoperative perineal wound complications remain a significant risk. Pelvic reconstruction lowers this risk, and a pedicled rectus abdominis muscle flap is frequently used to achieve this. Traditional flap harvest requires laparotomy, resulting in violation of both rectus sheaths and a large midline scar. Robotic harvest of the rectus abdominis muscle for pelvic reconstruction after abdominoperineal resection is a novel approach with foreseeable benefits. TECHNIQUE: After completion of abdominoperineal resection, 2 additional trocars are inserted in the lateral abdomen, and the robot is reoriented toward the posterior abdominal wall. The peritoneum and posterior rectus sheath are incised, and dissection is carried superiorly and inferiorly in a sagittal plane to reveal the rectus abdominis muscle. The muscle body is separated from the anterior rectus sheath. Once the inferior epigastric artery is identified, the superior pole of the muscle is transected. Continued lateral dissection ensures flap mobility for placement within the pelvis. After obtaining proper reach, the robot is undocked, and the flap is sutured in place through the perineal defect. RESULTS: After trocar placement and robot repositioning, both the colorectal and plastic surgeons trade places at the console. Robotic flap harvest precludes the need for laparotomy. The anterior rectus sheath remains unviolated and the patient avoids an additional midline scar. The aforementioned benefits of robot-assisted abdominoperineal resection, namely increased visualization and maneuverability, were also found applicable when robotically harvesting this flap. CONCLUSIONS: This technique exemplifies an additional minimally invasive technique for patients pursuing abdominoperineal resection. With knowledge of this novel approach, surgeons can better tailor their operations to benefit the patient.


Assuntos
Períneo/cirurgia , Protectomia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reto do Abdome/transplante , Procedimentos Cirúrgicos Robóticos/métodos , Retalhos Cirúrgicos/transplante , Cirurgia Colorretal , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Terapia Neoadjuvante , Cirurgia Plástica
18.
Medicine (Baltimore) ; 99(46): e22988, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181662

RESUMO

The aim of this study is to investigate the feasibility and advantages of the da Vinci robotic system with the "3 + 2" mode (3 robotic arms and 2 assistants) in radical gastrectomy for gastric cancer.The clinical data of 65 patients who underwent da Vinci robotic gastrectomy with the "3 + 2" mode from July 2016 to October 2019 were grouped into an observation group. An additional 65 patients who underwent robotic gastrectomy under the classic mode during the same period were grouped into a control group. The short-term surgical outcomes were compared between 2 different groups.Compared with the control group, the observation group had a significantly shorter operative time (176.18 ±â€Š15.49 vs 203.85 ±â€Š12.77 minutes, P < .001) and lower operation costs ($2761.19 ±â€Š$191.91 vs $3690.91 ±â€Š$162.82; P < .001). No statistical differences in other outcomes were observed (P > .05).We show that robotic gastrectomy with "3 + 2" mode is a safe and beneficial surgical procedure in new robotic surgery institutions.


Assuntos
Gastrectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Gástricas/cirurgia , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Resultado do Tratamento
19.
Yonsei Med J ; 61(12): 1054-1059, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33251780

RESUMO

PURPOSE: Here, we compared the operative and perioperative outcomes between robot-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM) in patients with large (>10 cm) or heavy myomas (>250 g). MATERIALS AND METHODS: We included 278 patients who underwent multi-port RALM (n=126) or AM (n=151) for large or heavy myomas in a tertiary care hospital between April 2019 and June 2020. The t-test, chi-square, Bonferroni's test, and multiple linear regression were used. RESULTS: No differences were observed in age, body mass index, parity, or history of pelvic surgery between the two groups. Myoma diameters were not different (10.8±2.52 cm vs. 11.2±3.0 cm, p=0.233), but myomas were lighter in the RALM group than in the AM group (444.6±283.14 g vs. 604.68±368.35 g, respectively, p=0.001). The RALM group had a higher proportion of subserosal myomas, fewer myomas, fewer large myomas over >3 cm, lighter myomas, and longer total operating time. However, the RALM group also had shorter hospital stay and fewer short-term complications. Estimated blood loss (EBL) was not different between the two groups. The number of removed myomas was the most significant factor (coefficient=10.89, p<0.0001) affecting the EBL. CONCLUSION: RALM is a feasible myomectomy technique even for large or heavy myomas. RALM patients tend to have shorter hospital stays and fewer postoperative fevers within 48 hours. However, RALM has longer total operating time.


Assuntos
Laparoscopia/métodos , Leiomioma/cirurgia , Técnicas de Abdome Aberto/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia , Adulto , Feminino , Humanos , Leiomioma/patologia , Tempo de Internação , Pessoa de Meia-Idade , Duração da Cirurgia , Gravidez , Estudos Retrospectivos , Robótica , Resultado do Tratamento , Neoplasias Uterinas/patologia
20.
J Cancer Res Clin Oncol ; 146(12): 3297-3312, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33108513

RESUMO

PURPOSE: Robotic surgical system has been gradually applied in thyroid neoplasms as a novel treatment for years, with presenting some superiorities as well as limitations. To compare the effectiveness and safety of robotic surgery with open surgery for the patients with thyroid neoplasms, this review was conducted METHODS: We performed electronic search in CENTRAL, MEDLINE, EMBASE, CNKI, CBM, Opengray, and Sciencepaper Online databases and manual search in specific online databases and according to the reference list of relevant papers to get all the studies that compared the effectiveness and safety of robotic surgery with that of open surgery for patients with thyroid neoplasms. Last update was conducted in March 2020. Randomized-controlled trials, case-control studies, cohort studies, and cross-sectional surveys were all included. RESULTS: In this review, 59 studies were included: two RCTs, 15 NRSs, 40 cohort studies, and two cross-sectional studies. Robotic surgery was found to be associated with longer operative duration, less retrieved lymph nodes, higher postoperative thyroglobulin before radioactive iodine ablation, similar complication incidence but less blood loss, better functional recovery, and higher cosmetic satisfaction compared to open surgery. CONCLUSIONS: Robotic surgery is a safe and feasible approach with remarkable superiority in reducing intraoperative damage and improving patients' quality of life compared to open surgery for thyroid neoplasms. Meanwhile, this procedure is also associated with long operative duration, insufficient removal of neck lymph nodes, which need to be given careful consideration.


Assuntos
Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Gerenciamento de Dados , Humanos , Complicações Pós-Operatórias , Qualidade de Vida , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/tendências , Neoplasias da Glândula Tireoide/epidemiologia , Tireoidectomia/tendências , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA