title: Robotic single site versus robotic multiport hysterectomy in early endometrial cancer: a case control study.
abstract: OBJECTIVE
  To compare surgical outcomes and cost of robotic single-site hysterectomy (RSSH) versus robotic multiport hysterectomy (RMPH) in early stage endometrial cancer.
  
  
  METHODS
  This is a retrospective case-control study, comparing perioperative outcomes and costs of RSSH and RMPH in early stage endometrial cancer patients. RSSH were matched 1:2 according to age, body mass index, comorbidity, the International Federation of Gynecology and Obstetric (FIGO) stage, type of radical surgery, histologic type, and grading. Mean hospital cost per discharge was calculated summarizing the cost of daily hospital room charges, operating room, cost of supplies and length of hospital stay.
  
  
  RESULTS
  A total of 23 women who underwent RSSH were matched with 46 historic controls treated by RMPH in the same institute, with the same surgical team. No significant differences were found in terms of age, histologic type, stage, and grading. Operative time was similar: 102.5 minutes in RMPH and 110 in RSSH (p=0.889). Blood loss was lower in RSSH than in RMPH (respectively, 50 mL vs. 100 mL, p=0.001). Hospital stay was 3 days in RMPH and 2 days in RSSH (p=0.001). No intraoperative complications occurred in both groups. Early postoperative complications were 2.2% in RMPH and 4.3% in RSSH. Overall cost was higher in RMPH than in RSSH (respectively, $7,772.15 vs. $5,181.06).
  
  
  CONCLUSIONS
  Our retrospective study suggests the safety and feasibility of RSSH for staging early endometrial cancer without major differences from the RMPH in terms of surgical outcomes, but with lower hospital costs. Certainly, further studies are eagerly warranted to confirm our findings.
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy. giacomo.corrado@alice.it.
authors.forename: Giacomo
authors.identifier: http://orcid.org/0000-0002-8319-6146
authors.initials: G
authors.lastname: Corrado
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0001-9526-0443
authors.initials: G
authors.lastname: Cutillo
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Emanuela
authors.identifier: http://orcid.org/0000-0002-9946-7289
authors.initials: E
authors.lastname: Mancini
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Ermelinda
authors.identifier: http://orcid.org/0000-0002-5719-5561
authors.initials: E
authors.lastname: Baiocco
authors.affiliation: Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.
authors.forename: Lodovico
authors.identifier: http://orcid.org/0000-0002-3331-9750
authors.initials: L
authors.lastname: Patrizi
authors.affiliation: Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0002-6168-8246
authors.initials: M
authors.lastname: Saltari
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Anna
authors.identifier: http://orcid.org/0000-0001-6039-1558
authors.initials: A
authors.lastname: di Luca Sidozzi
authors.affiliation: Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Isabella
authors.identifier: http://orcid.org/0000-0003-0831-2765
authors.initials: I
authors.lastname: Sperduti
authors.affiliation: Surgery Department, Section of Gynecology and Obstetrics, Tor Vergata University, Rome, Italy.
authors.forename: Giulia
authors.identifier: http://orcid.org/0000-0001-6715-5443
authors.initials: G
authors.lastname: Pomati
authors.affiliation: Surgical Oncology Department, Gynecologic Oncology Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Enrico
authors.identifier: http://orcid.org/0000-0001-5975-1202
authors.initials: E
authors.lastname: Vizza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000191:economics / Q000601:surgery*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*
keywords: Endometrial Neoplasms; Minimally Invasive Surgical Procedures; Robotic Hysterectomy; Robotic Single Site Hysterectomy