title: Robot-assisted surgery in cervical cancer patients reduces the time to normal activities of daily living.
abstract: OBJECTIVE
  To evaluate current surgical cervical cancer treatment in Sweden 2008-12.
  
  
  METHODS
  Analysis of data in the Swedish National Quality Register for Gynecological Surgery (GynOP).
  
  
  METHODS
  A total of 249 cervical cancer patients undergoing surgery.
  
  
  METHODS
  Analysis of prospectively gathered preoperative and postoperative data including patient-reported information.
  
  
  METHODS
  Mean operating time, blood loss/transfusion, length of hospital stay, return to activities of daily living.
  
  
  RESULTS
  The patients undergoing laparoscopic robot-assisted surgery (n = 64) or laparotomy (n = 185) did not differ in age, body mass index, American Society of Anesthesiologists score, International Federation of Gynecology and Obstetrics (FIGO) stage or mean operating time. Blood loss was higher in the laparotomy group (p < 0.001). Thirteen patients in the laparotomy group (7%) received a blood transfusion, but none in the robot group. Intraoperative complications were more common in the laparotomy group (p = 0.03). Re-admission or operations did not differ between the groups. The number of pelvic lymph nodes removed was significantly higher in the laparotomy group (median 31 vs. 24, p < 0.001). There was no difference regarding the number of patients with lymph node metastases in the two groups. The postoperative length of hospital stay was longer in the laparotomy group compared with the robot group (6.1 days vs. 2.1 days, p = 0.01). The patient-reported time to resume normal activities of daily living was longer in the laparotomy than the robot group (13.4 days vs. 9.7 days, p = 0.04).
  
  
  CONCLUSIONS
  Laparoscopic robotic-assisted surgery is preferable to laparotomy for cervical cancer patients because it entails a significantly shorter hospital stay, less blood loss, fewer intraoperative complications and shorter time to normal daily activities.
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund, Sweden.
authors.forename: Katrin C
authors.initials: KC
authors.lastname: Asciutto
authors.forename: Grigorios
authors.initials: G
authors.lastname: Kalapotharakos
authors.forename: Mats
authors.initials: M
authors.lastname: Löfgren
authors.forename: Thomas
authors.initials: T
authors.lastname: Högberg
authors.forename: Christer
authors.initials: C
authors.lastname: Borgfeldt
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D020127:Recovery of Function; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D016387:Women's Health
keywords: Cervical cancer; activities of daily living; laparoscopy; robot; surgery