子宫内膜癌微创手术循证:从技术安全到精准决策OA

Over the past three decades,minimally invasive surgery has been widely adopted in the treatment of endometrial cancer.Robotic-assisted surgery has expanded the clinical application scope of minimally invasive procedures,demonstrating favorable safety profiles and oncological outcomes even in complex clinical scenarios,including advanced age and morbid obesity.However,minimally invasive surgery also faces challenges.Long-term follow-up studies suggest that the use of uterine manipulators may be associated with a risk of tumor dissemination,while molecular subtypes of tumors—such as TP53 mutation and microsatellite stability(MSS)—may influence surgical prognosis.This article systematically reviews the developmental history,evidence-based foundations,clinical concerns,and future directions of minimally invasive surgical treatment for endometrial cancer.It is recommended that,on the basis of ensuring oncological safety,treatment decisions during the perioperative period should integrate patient pathology,imaging findings,and molecular subtype characteristics,Furthermore,standardized training for clinicians at all levels should be strengthened to facilitate the transition of perioperative treatment decision-making for endometrial cancer from technical safety toward precision-based individualized care.