Clinical comparison of robotic, laparoscopic, and open hysterectomy procedures for endometrial cancer patients.
The goal of this study was to compare outcomes for robotic, laparoscopic, and open hysterectomy procedures for endometrial cancer as well as to investigate whether specific patient demographic, comorbidity, and severity variables were associated with the type of hysterectomy performed. A retrospective review was conducted of hysterectomy procedures for patients discharged from October 1, 2008 and September 30, 2012. Preoperative characteristics included age, BMI, number of past abdominal surgeries, and comorbidities. Intraoperative and postoperative characteristics included uterine weight and diameter, American Society of Anesthesiologists physical status classification, lymph-vascular space involvement, FIGO stage and tumor grade. Outcomes included operative time, estimated blood loss, length of stay, conversion to open, other intraoperative and postoperative complications, readmissions within 30 days and lymph node yield. The robotic and laparoscopic cohorts show no significant differences in patient or tumor characteristics, while the open cases represent patients with increased complexity. In general, laparoscopic cases were shorter than robotic and open cases. Laparoscopic cases had fewer conversions to open than robotic cases. Robotic and open cases had significantly higher lymph node yield than laparoscopic cases. The reduction in surgical time and conversion rates in the laparoscopic cohort may be related to the reduction in node dissection performed.
Quality Improvement, Crouse Health Hospital, 736 Irving Avenue, Syracuse, NY, 13210, USA. lynettejohnson@crouse.org.
Lynette
http://orcid.org/0000-0001-9215-5226
L
Johnson
GYN Oncology of CNY, SUNY Upstate Medical University, 475 Irving Avenue, Suite 204A, Syracuse, NY, 13210, USA.
W Douglas
WD
Bunn
Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
Loan
L
Nguyen
Syracuse University Department of Public Health, c/o Crouse Health Hospital Quality Improvement, 736 Irving Avenue, Syracuse, NY, 13210, USA.
Jessica
J
Rice
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
Minakshi
M
Raj
GYN Oncology of CNY, SUNY Upstate Medical University, 475 Irving Avenue, Suite 204A, Syracuse, NY, 13210, USA.
Mary J
MJ
Cunningham
D016063:Blood Loss, Surgical; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
Endometrial cancer; Hysterectomy; Laparoscopic; Robotic