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A Comparison of the Clinical Outcomes in Uterine Cancer Surgery After the Introduction of Robotic-Assisted Surgery

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Abstract

Objective

To compare the rates of intraoperative and postoperative complications of open and robotic-assisted surgery in the treatment of endometrial cancer.

Methods

This retrospective study was performed at a single academic institution from January 2014 to February 2017 in the Department of Gynecology Oncology at Amrita Institute of Medical Science, Kerala, India. The study included patients with clinically early stage uterine malignancy undergoing open or robotic-assisted surgery. Data collected included clinicopathological factors, intraoperative data, length of hospital stay and intraoperative and postoperative (early and late and severity according to Clavien–Dindo classification). Morbidity was compared between two groups.

Results

The study included 128 patients, of whom 61 underwent open surgery and 67 underwent robotic-assisted surgery. Mean operative time (P = 0.112), mean estimated blood loss (P < 0.001), number of patients requiring blood transfusion (P < 0.001) and mean length of hospital stay (P < 0.001) were significantly lower in robotic group. None of the patients in robotic group experienced intraoperative hemorrhage (P = 0.010). The early postoperative complications, SSI (P < 0.001), infection (P = 0.002), and urinary complications (P = 0.030) and late postoperative complications lymphoedema (P = 0.002), vault-related complications (1.5% robotic vs. 6.6% open) and incisional hernia (none in robotic vs. 4.9% in open) were significantly lower in robotic group. Grade-II complications (Clavien–Dindo classification) were significantly lower in robotic group (P < 0.001).

Conclusion

Robotic-assisted surgical staging for uterine cancer is feasible and safe in terms of short-term outcomes and results in fewer complications and shorter hospital stay.

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Authors and Affiliations

  1. Department of Gynecologic Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, 682041, India

    Reshu Agarwal, Anupama Rajanbabu & Gaurav Goel

  2. Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India

    U. G. Unnikrishnan

Authors
  1. Reshu Agarwal
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  2. Anupama Rajanbabu
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  3. Gaurav Goel
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  4. U. G. Unnikrishnan
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Corresponding author

Correspondence to Anupama Rajanbabu.

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Conflict of interest

Authors have no financial conflict of interest to declare.

Ethical Statement

Ethical committee permission was obtained.

Additional information

Dr. Reshu Agarwal had finished her Fellowship in Department of Gynecologic Oncology at Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India; Dr. Anupama Rajanbabu is a professor in Department of Gynecologic Oncology at Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India; Dr. Gaurav Goel is a Post Graduate Trainee in Department of Gynecologic Oncology at Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India. U. G. Unnikrishnan is a Lecturer in Department of Biostatistics, Amrita University, Kochi, Kerala, India.

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Agarwal, R., Rajanbabu, A., Goel, G. et al. A Comparison of the Clinical Outcomes in Uterine Cancer Surgery After the Introduction of Robotic-Assisted Surgery. J Obstet Gynecol India 69, 284–291 (2019). https://doi.org/10.1007/s13224-018-1170-0

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  • DOI: https://doi.org/10.1007/s13224-018-1170-0

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