Comparison between 155 cases of robotic vs. 150 cases of open surgical staging for endometrial cancer.
OBJECTIVE
To compare the outcomes of 155 cases of endometrial cancer who had robot-assisted surgical staging to 150 open cases.


METHODS
Retrospective chart review of cases of endometrial cancer that underwent staging two different ways by two surgeons at an academic institution.


RESULTS
Mean age was 62.4 years in the robotic arm and 65 (P=0.04) in the open arm. Mean body mass index was 34.5 Kg/m(2) in the robotic arm and 33 Kg/m(2) in the open arm (P=0.2). Pelvic and para-aortic lymph node dissection were performed in 94.8% and 67.7% of the robotic cases versus 95.3% and 74% of the open cases, respectively. Mean operative time was 127 min in the robotic arm, and 141 min in the open arm (P=0.0001). Mean lymph node count was 20.3 in the robotic arm, and 20 in the open arm (P=0.567). Mean estimated blood loss was 119 ml in the robotic arm and 185 in the open arm (P=0.015). Mean hospital stay was 1.5 days in the robotic arm, and 4 days in the open arm (P=0.0001). The incidence of postoperative ileus (0.6% vs. 10.7%, P=0.0001), infections (5.2% vs. 24%, P=0.0001), anemia/transfusion (1.3% vs. 7.7%, P=0.005), and cardiopulmonary complications (3.2% vs.14.7%, P=0.003) was significantly lower in the robotic arm vs. the open arm. There was one death in the robotic arm attributed to pre-existing cardiac condition.


CONCLUSIONS
Robotic-assisted staging reaps the benefits of minimally invasive surgery without compromising the adequacy of the procedure. Dedication to the technique shortens the operative time.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520-8063, USA.
Karim S
KS
ElSahwi
Charlene
C
Hooper
Maria C
MC
De Leon
Taryn N
TN
Gallo
Elena
E
Ratner
Dan-Arin
DA
Silasi
Alessandro D
AD
Santin
Peter E
PE
Schwartz
Thomas J
TJ
Rutherford
Masoud
M
Azodi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D012371:Robotics / Q000379:methods*