Safety and effectiveness of robotic hysterectomy versus conventional laparoscopic hysterectomy in patients with cervical cancer in China
- 61 Downloads
The aim of this study was to compare the safety and effectiveness of robotic hysterectomy (RH) with conventional laparoscopic hysterectomy (LH) for the treatment of cervical cancer using multivariate regressions.
We designed a retrospective single-center study and consecutively collected patients with cervical cancer from February 2014 to October 2017. Data extraction was performed by two independent researchers. The surgical outcomes include operative time, estimated blood loss, number of lymph nodes, time to first flatus, time to a full diet, time to remove drainage tube, length of hospital stay, and postoperative complication.
A total of 152 patients with cervical cancer were collected in our study including 92 patients who underwent RH and 60 patients who underwent LH. Both groups have similar characteristics. The RH group showed shorter operative time (Coe − 42.89; 95% CI − 74.39 to 11.39; P = 0.008) and more number of lymph nodes (Coe 6.06; 95% CI 2.46–9.66; p = 0.001) than the LH group. As for the postoperative parameters, the RH group showed shorter time to remove drainage tube (Coe − 0.89; 95% CI –1.62 to –0.15; p = 0.019) and length of hospital stay (Coe − 6.40; 95% CI − 10.19 to − 2.95; p = 0.001). No significant difference was found between the groups in estimated blood loss (Coe 34.64; 95% CI − 33.08 to 102.37; p = 0.314), time to first flatus (Coe 0.11; 95% CI − 0.38 to 0.61; p = 0.652), time to a full diet (Coe − 0.24; 95% CI − 0.54 to 0.06, p = 0.118), and postoperative complication (OR 0.84; 95% CI 0.35–1.98; p = 0.685).
The results from this study suggest that RH is safe and effective as LH but robotic surgery significantly contributed to the feasibility of alternative treatment options for cervical cancer patients.
KeywordsCervical cancer Robotic hysterectomy Conventional laparoscopic hysterectomy
Jing Wang, Fan Hou, Li-Yuan Xu, and Rong-hua Feng from the Lanzhou University participated in the data collection and submission of the corresponding manuscript.
LH: design of the study, data collection, data analysis, responsible for surgery, and manuscript writing. PY: design of the study and data analysis. LY: design of the study. RL: design of the study. RS: data collection. JL: responsible surgery. LW: data collection. XC: responsible surgery. KY: design of the study. TG: design of the study. HW: design of the study and responsible for surgery.
Compliance with ethical standards
Conflict of interest
We declare that we have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of Gansu Provincial Hospital, China (Reference number: 2017-067).
Informed consent was obtained from all individual participants.
- 9.Kim JY, Lee YH, Chong GO, Lee YS, Cho YL, Hong DG (2015) Comparative study between total laparoscopic and total robotic radical hysterectomy for cervical carcinoma: clinical study. Anticancer Res 35:5015–5021Google Scholar
- 11.Corrado G, Cutillo G, Saltari M, Mancini E, Sindico S, Vici P, Sergi D, Sperduti I, Patrizi L, Pomati G, Baiocco E, Vizza E (2016) Surgical and oncological outcome of robotic surgery compared with laparoscopic and abdominal surgery in the management of locally advanced cervical cancer after neoadjuvant chemotherapy. Int J Gynecol Cancer 26:539–546CrossRefGoogle Scholar
- 12.Corrado G, Fanfani F, Ghezzi F, Fagotti A, Uccella S, Mancini E, Sperduti I, Stevenazzi G, Scambia G, Vizza E (2015) Mini-laparoscopic versus robotic radical hysterectomy plus systematic pelvic lymphadenectomy in early cervical cancer patients. A multi-institutional study. Eur J Surg Oncol 41:136–141CrossRefGoogle Scholar
- 15.Pellegrino A, Damiani GR, Loverro M, Pirovano C, Fachechi G, Corso S, Trojano G (2017) Comparison of robotic and laparoscopic radical type-b and c hysterectomy for cervical cancer: long term-outcomes. Acta Biomed 88:289–296Google Scholar
- 17.Nam EJ, Kim SW, Kim S, Kim JH, Jung YW, Paek JH, Lee SH, Kim JW, Kim YT (2010) A case-control study of robotic radical hysterectomy and pelvic lymphadenectomy using 3 robotic arms compared with abdominal radical hysterectomy in cervical cancer. Int J Gynecol Cancer 20:1284–1289CrossRefGoogle Scholar
- 30.Marino P, Houvenaeghel G, Narducci F, Boyer-Chammard A, Ferron G, Uzan C, Bats AS, Mathevet P, Dessogne P, Guyon F, Rouanet P, Jaffre I, Carcopino X, Perez T, Lambaudie E (2015) Cost-effectiveness of conventional vs robotic-assisted laparoscopy in gynecologic oncologic indications. Int J Gynecol Cancer 25:1102–1108CrossRefGoogle Scholar