G Corrado1, G Cutillo2, G Pomati3, E Mancini2, I Sperduti4, L Patrizi3, M Saltari3, C Vincenzoni2, E Baiocco2, E Vizza2. 1. Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy. Electronic address: giacomo.corrado@alice.it. 2. Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy. 3. Department of Surgery, Section of Gynaecology and Obstetrics, Tor Vergata University, Rome, Italy. 4. Scientific Direction, "Regina Elena" National Cancer Institute, Rome, Italy.
Abstract
OBJECTIVE: To compare different techniques of minimally invasive surgery (laparoscopy and robotics) to abdominal surgery in order to identify the optimal surgical technique in the treatment of endometrial cancer. METHODS AND MATERIALS: A single-institutional, matched, retrospective, cohort study was performed. All patients with clinical stage I or occult stage II endometrial cancer who underwentrobotic hysterectomy, bilateral salpingo-oophorectomy± lymphadenectomy from August 2010 and December 2013 were identified. Surgical and oncological outcomes were compared with patients matched by age, body mass index, tumor histology, and grade, who underwent abdominal or laparoscopic surgery between January 2001 and December 2013. RESULTS: Three groups were identified: 177 laparotomies (group A), 277 laparoscopies (group B) and 72 robotics (group C). There were no statistically significant differences between the three groups in terms of age, BMI and FIGO stage. The operative time was shortest in group B (p = 0.0001). Blood loss and transfusions were equivalent in group B and C, while they were greater in group A (p = 0.0001). The intra-operative, early and late postoperative complications, rate of conversion, the re-intervention and median hospital stay were lower in group C. The rate of recurrence and death from disease was similar in all three groups. CONCLUSIONS:Minimally invasive surgery was superior to abdominal surgery in terms of surgical outcomes. Robotic surgery was superior to laparoscopy in terms of intra- and post-operative complications, conversion rates, length of hospital stay and re-interventions. In terms of oncological outcomes the three groups were equivalent.
RCT Entities:
OBJECTIVE: To compare different techniques of minimally invasive surgery (laparoscopy and robotics) to abdominal surgery in order to identify the optimal surgical technique in the treatment of endometrial cancer. METHODS AND MATERIALS: A single-institutional, matched, retrospective, cohort study was performed. All patients with clinical stage I or occult stage II endometrial cancer who underwent robotic hysterectomy, bilateral salpingo-oophorectomy ± lymphadenectomy from August 2010 and December 2013 were identified. Surgical and oncological outcomes were compared with patients matched by age, body mass index, tumor histology, and grade, who underwent abdominal or laparoscopic surgery between January 2001 and December 2013. RESULTS: Three groups were identified: 177 laparotomies (group A), 277 laparoscopies (group B) and 72 robotics (group C). There were no statistically significant differences between the three groups in terms of age, BMI and FIGO stage. The operative time was shortest in group B (p = 0.0001). Blood loss and transfusions were equivalent in group B and C, while they were greater in group A (p = 0.0001). The intra-operative, early and late postoperative complications, rate of conversion, the re-intervention and median hospital stay were lower in group C. The rate of recurrence and death from disease was similar in all three groups. CONCLUSIONS: Minimally invasive surgery was superior to abdominal surgery in terms of surgical outcomes. Robotic surgery was superior to laparoscopy in terms of intra- and post-operative complications, conversion rates, length of hospital stay and re-interventions. In terms of oncological outcomes the three groups were equivalent.
Authors: Slavcho T Tomov; Grigor A Gorchev; Desislava K Kiprova; Aleksandar D Lyubenov; Nadezhda H Hinkova; Vesela D Tomova; Zornitsa V Gorcheva; Sarfraz Ahmad Journal: J Robot Surg Date: 2022-02-10
Authors: Jvan Casarin; Francesco Multinu; Nadeem Abu-Rustum; David Cibula; William A Cliby; Fabio Ghezzi; Mario Leitao; Ikuo Konishi; Joo-Hyun Nam; Denis Querleu; Pamela T Soliman; Kathleen J Yost; Amy L Weaver; Andrea Mariani; Gretchen E Glaser Journal: Int J Gynecol Cancer Date: 2019-01 Impact factor: 3.437
Authors: Maria B Schiavone; Maciej S Bielen; Ginger J Gardner; Oliver Zivanovic; Elizabeth L Jewell; Yukio Sonoda; Richard R Barakat; Dennis S Chi; Nadeem R Abu-Rustum; Mario M Leitao Journal: Gynecol Oncol Date: 2016-01-08 Impact factor: 5.482