title: Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer.
abstract: BACKGROUND
  Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes.
  
  
  METHODS
  A non-randomised, controlled before and after study of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls).
  
  
  RESULTS
  RALH had significant advantages compared with TAH: fewer and less severe post-operative complications and a shorter length of hospital stay. The absolute risk reduction for post-operative complications was 13% (95% confidence interval: 4.29-20.87%). Women treated with TAH had significantly more severe complications (grade ≥ 3) than those treated with RALH; 12% versus 3% (p = 0.001). Infections (urinary and port site) were the most frequent post-operative complications overall. The duration of RALH in the operation theatre was longer, while the duration of stay in the post-anaesthesia care unit was shorter for patients undergoing RALH.
  
  
  CONCLUSIONS
  RALH appears advantageous for women treated for endometrial cancer in terms of post-operative complications. We recommend the use of the Clavien-Dindo classification of surgical outcomes for quality assessment.
  
  
  BACKGROUND
  departmental only.
  
  
  BACKGROUND
  Danish Health Authority (3-2013-111/1/KAHO).
authors.affiliation: suzanne.herling@gmail.com.
authors.forename: Suzanne Forsyth
authors.initials: SF
authors.lastname: Herling
authors.forename: Ann M
authors.initials: AM
authors.lastname: Møller
authors.forename: Connie
authors.initials: C
authors.lastname: Palle
authors.forename: Anja
authors.initials: A
authors.lastname: Grynnerup
authors.forename: Thordis
authors.initials: T
authors.lastname: Thomsen
mesh_terms: D000368:Aged; D065187:Controlled Before-After Studies; D003718:Denmark; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*