Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging
Abstract
:1. Introduction
2. Materials and Methods
2.1. Objectives and PICO Process
2.2. Search Strategy
2.3. Inclusion and Exclusion Criteria
2.4. Data Extraction
2.5. Risk of Bias
3. Results
4. Discussion
5. Prognostic Factors
6. Preoperative Imaging for Planning Pelvic Exenteration
6.1. Magnetic Resonance Imaging
6.2. Compartment-Based Imaging
6.3. Positron-Emission Tomography-Computerized Tomography
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
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Author | Year | Number of Patients | Type of Exenteration | Total Operative Time (mins) | EBL (mL) | Early Postop Complications | Late Postop Complications | Hospital Stay (Days-Range) | Median Follow-Up (Months-Range) | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
Lim [13] | 2009 | 1 | TPE | 375 | 375 | none | NS | 10 | NS | NS |
Lambaudi et al. [25] | 2010 | 3 | APE | 480 | 400 | none | Fistula, UTI, ureteral stenosis, perineal abscess | 30 | 2–12 | DFS = 9 m |
Davis et al. [26] | 2010 | 2 | APE | 540 | 550 | NS | NS | 8 | NS | Recurrence after 8 and 23 m |
Jauffret et al. [27] | 2011 | 2 | APE | 480 | 300 | none | Wound dehiscence, fistula, sepsis, urosepsis, prerenal failure, obstructive renal failure | 6 (3–24) | 23 | DFS = 5 m and 8 m, OS = 22 m and 23 m |
Lawande et al. [28] | 2014 | 1 | TPE | 240 | 300 | none | none | 11 | 2 | NS |
Puntambekar et al. [10] | 2014 | 10 | APE | 180 | 110 | none | none | 5 | 11 | Disease free: 8 patients |
Konstantinidis et al. [29] | 2017 | 1 | TPE | 641 | 400 | NS | NS | NS | NS | NS |
Nguyen Xuan et al. [30] | 2018 | 5 | APE (n = 2) PPE (n = 2) TPE (n = 1) | 390–480 | NS | 4 UTI, 1 PE, 1 sepsis | Wound infection, stenosis ileal anastomosis, renal failure, pulmonary embolism | 11.5 | NS | 3 recurrences after 7 m, 1 died after 10 m |
Yang et al. [31] | 2018 | 1 | TPE | 700 | 300 | none | Fistula | 37 | 17 | no recurrence |
Bizzarri et al. [19] | 2019 | 11 | APE | 500 | 235 | none | 27.3% of cases | 9 | 15 | DFS = 11 m |
Jain et al. [32] | 2021 | 14 | APE | 305 | 135 | 36% of cases: urosepsis, anastomosis leak, ileus, fistula, intestinal obstruction | 28.6% of cases: colon perforation, UTI, large bowel obstruction, bleeding, ureteral stricture | 6.5 | 17.5 (10–68) | 5 deaths, 12 m DFS = 68.2%, 12 m OS: 77.1% |
Dudus et al. [33] | 2024 | 12 | APE (n = 6) TPE (n = 6) | 360 440 | 350 | Morbidity: 16.6%, urinoma, wound infection | Pyelonephritis, hydronephrosis, thrombophlebitis, renal failure, bowel obstruction, iliac artery fistula | 18 (6–38) | 24 | 50% alive, DFS = 12 m, OS = 20 m |
MRI Compartment Name | Anatomical Structures |
---|---|
Peritoneal reflection compartment (PR) | Peritoneum (covering Douglas and vesico-uterine space |
Anterior above peritoneal reflection compartment (AA) | Abdominal cavity with intestines, mesenteric and omental fat, Retroperitoneal space with proximal two thirds of the ureter, ovarian vessels, genitofemoral nerve, iliopsoas muscle |
Anterior below peritoneal reflection compartment (AB) | Bladder, urethra, Retzius space, vesico-ureteral junction, superior/inferior vesical vessels, ureter and bladder nerve branches from inferior hypogastric plexus, vesico-uterine ligament |
Central compartment (C) | Uterine corpus, uterine cervix, proximal round ligaments, parametrium, vagina, paracolpium, uterine and vaginal vessels |
Posterior below peritoneal reflection compartment (PB) | Rectum, mesorectum, splanchnic branches from the superior/inferior hypogastric plexus and hypogastric nerves, rectosigmoid junction |
Lateral compartment (L) | Parietal pelvic fascia, inferior hypogastric nerve in meso-ureter, distal third of ureter, iliac vessels, iliac and obturator lymph nodes, sacral nerve plexus, obturator nerve, internal obturator muscle, piriformis muscle, lumbosacral trunk, ovaries, fallopian tubes |
Inferior compartment (I) | Anorectal junction, pelvic floor muscles, levator ani muscle, transverse perineal muscle (urogenital diaphragm), perineal body, pudendal vessels and nerves |
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Van Trappen, P.; Walgraeve, M.-S.; Roels, S.; Claes, N.; De Cuypere, E.; Baekelandt, F.; Arentsen, H. Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging. J. Clin. Med. 2024, 13, 3673. https://doi.org/10.3390/jcm13133673
Van Trappen P, Walgraeve M-S, Roels S, Claes N, De Cuypere E, Baekelandt F, Arentsen H. Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging. Journal of Clinical Medicine. 2024; 13(13):3673. https://doi.org/10.3390/jcm13133673
Chicago/Turabian StyleVan Trappen, Philippe, Marie-Sofie Walgraeve, Sarah Roels, Nele Claes, Eveline De Cuypere, Frederic Baekelandt, and Harm Arentsen. 2024. "Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging" Journal of Clinical Medicine 13, no. 13: 3673. https://doi.org/10.3390/jcm13133673
APA StyleVan Trappen, P., Walgraeve, M.-S., Roels, S., Claes, N., De Cuypere, E., Baekelandt, F., & Arentsen, H. (2024). Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging. Journal of Clinical Medicine, 13(13), 3673. https://doi.org/10.3390/jcm13133673