PROBLEMS IN MALIGNANT TUMORS STAGING AND INNOVATIVE SURGICAL TECHNIQUES

Abstract

Innovations in medicine affect everyone. The question to what extent a given innovation can be
reconciled with the disease itself and its course so as to obtain a positive result of the treatment remains open. The
aim of the study is to determine at what stage of development of the oncological disease in gynecology surgical
intervention is carried out by means of robot-assisted surgery. A statistical method was used. The data were
processed using the Microsoft Excel program. A total of two hundred and five cases of robot-assisted gynecological
surgery were studied, divided into two groups according to the location of the tumor - the body of the uterus and the
cervix. One hundred and thirty-eight cases were found to be malignant neoplasms of the body of the uterus and
sixty-seven cases to be malignant neoplasms of the cervix, over a one-year period. Based on the staging of the tumor
according to the TNM classification, it was reported at what stage of the disease the surgical intervention was
carried out through robot-assisted surgery. The ratio by localization of a malignant neoplasm in gynecology is sixtyseven
percent for endometrial carcinoma and thirty-three percent. Of the thirty-eight cases of carcinoma of the
uterine body, one hundred and three patients or seventy-five percent were registered in the T1a stage, twenty-six
cases or nineteen percent in the T1b stage, and eight patients or six percent in the T2 stage . Of the sixty-seven cases
of carcinoma of the cervix, fifteen patients or twenty-three percent were registered in the T1a stage, forty cases or
sixty in the T1b stage, and twelve patients or eighteen percent in the T2 stage. Discussion: In carcinoma of the body
and cervix, robot-assisted surgery has been found to operate in patients with stage II carcinoma as well as sarcoma.
It follows that the treatment strategy was determined based on clinical staging, namely: examination, biopsy and
imaging studies. With the technology, it would not be able to accurately assess the presence of nearby metastases, a
prerequisite for desemination. The thesis is supported by the fact that some patients undergo chemotherapy.
Establishing precise criteria for the application of robot-assisted surgery in oncological diseases is of urgent
importance for patient survival and cure. Conclusion: Currently, the main problems facing robot-assisted surgery in
gynecology are: Tumor staging; The participation and commitment of the oncology commissions in determining the
treatment strategy for cancer patients; Costing and cost-benefit analysis. There is a need for: Determination of the
exact criteria at which stage robot-assisted surgery should be applied in gynecology (for example - first).
Conducting a cohort study for Bulgaria, regarding survival and quality of life in patients treated by robot-assisted
surgery. Study of the "Cost-Benefit" ratio in the given type of carcinomas