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Safety and effectiveness of robotic hysterectomy versus conventional laparoscopic hysterectomy in patients with cervical cancer in China

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusion

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.

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References

  1. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30

    Article  Google Scholar 

  2. Choi CH, Lee JW, Lee YY, Kim HJ, Song T, Kim MK, Kim TJ, Kim BG, Bae DS (2012) Comparison of laparoscopic-assisted radical vaginal hysterectomy and laparoscopic radical hysterectomy in the treatment of cervical cancer. Ann Surg Oncol 19:3839–3848

    Article  PubMed  Google Scholar 

  3. Steed H, Rosen B, Murphy J, Laframboise S, De Petrillo D, Covens A (2004) A comparison of laparoscopic-assisted radical vaginal hysterectomy and radical abdominal hysterectomy in the treatment of cervical cancer. Gynecol Oncol 93:588–593

    Article  CAS  Google Scholar 

  4. Selman TJ, Luesley DM, Murphy DJ, Mann CH (2005) Is radical hysterectomy for early stage cervical cancer an outdated operation? BJOG 112:363–365

    Article  CAS  PubMed  Google Scholar 

  5. Sharma R, Bailey J, Anderson R, Murdoch J (2006) Laparoscopically assisted radical vaginal hysterectomy (Coelio-Schauta): a comparison with open Wertheim/Meigs hysterectomy. Int J Gynecol Cancer 16:1927–1932

    Article  CAS  PubMed  Google Scholar 

  6. Li G, Yan X, Shang H, Wang G, Chen L, Han Y (2007) A comparison of laparoscopic radical hysterectomy and pelvic lymphadenectomy and laparotomy in the treatment of ib–iia cervical cancer. Gynecol Oncol 105:176–180

    Article  PubMed  Google Scholar 

  7. Mendivil A, Holloway RW, Boggess JF (2009) Emergence of robotic assisted surgery in gynecologic oncology: American perspective. Gynecol Oncol 114:S24–S31

    Article  PubMed  Google Scholar 

  8. Nezhat C, Lavie O, Lemyre M, Unal E, Nezhat CH, Nezhat F (2009) Robot-assisted laparoscopic surgery in gynecology: scientific dream or reality? Fertil Steril 91:2620–2622

    Article  PubMed  Google Scholar 

  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 35:5015–5021

    PubMed  Google Scholar 

  10. Nie JC, Yan AQ, Liu XS (2017) Robotic-assisted radical hysterectomy results in better surgical outcomes compared with the traditional laparoscopic radical hysterectomy for the treatment of cervical cancer. Int J Gynecol Cancer 27:1990–1999

    Article  PubMed  PubMed Central  Google 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 26:539–546

    Article  PubMed  Google 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 41:136–141

    Article  CAS  PubMed  Google Scholar 

  13. Chen CH, Chiu LH, Chang CW, Yen YK, Huang YH, Liu WM (2014) Comparing robotic surgery with conventional laparoscopy and laparotomy for cervical cancer management. Int J Gynecol Cancer 24:1105–1111

    Article  PubMed  Google Scholar 

  14. Chong GO, Lee YH, Hong DG, Cho YL, Park IS, Lee YS (2013) Robot versus laparoscopic nerve-sparing radical hysterectomy for cervical cancer: a comparison of the intraoperative and perioperative results of a single surgeon’s initial experience. Int J Gynecol Cancer 23:1145–1149

    Article  PubMed  Google 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 88:289–296

    PubMed  PubMed Central  Google Scholar 

  16. Wallin E, Floter Radestad A, Falconer H (2017) Introduction of robot-assisted radical hysterectomy for early stage cervical cancer: Impact on complications, costs and oncologic outcome. Acta Obstet Gynecol Scand 96:536–542

    Article  PubMed  Google 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 20:1284–1289

    Article  PubMed  Google Scholar 

  18. Vizza E, Mancini E, Baiocco E, Vicenzoni C, Patrizi L, Saltari M, Cimino M, Sindico S, Corrado G (2012) Robotic transperitoneal aortic lymphadenectomy in gynecologic cancer: a new robotic surgical technique and review of the literature. Ann Surg Oncol 19:3832–3838

    Article  PubMed  Google Scholar 

  19. Bandera CA, Magrina JF (2009) Robotic surgery in gynecologic oncology. Curr Opin Obstet Gynecol 21:25–30

    Article  PubMed  Google Scholar 

  20. Renato S, Mohamed M, Serena S, Giulia M, Giulia F, Giulia G, Diego R, Riccardo S (2011) Robot-assisted radical hysterectomy for cervical cancer: Review of surgical and oncological outcomes. ISRN Obstet Gynecol 2011:872434

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kim TH, Choi CH, Choi JK, Yoon A, Lee YY, Kim TJ, Lee JW, Bae DS, Kim BG (2014) Robotic versus laparoscopic radical hysterectomy in cervical cancer patients: a matched-case comparative study. Int J Gynecol Cancer 24:1466–1473

    Article  PubMed  Google Scholar 

  22. Yim GW, Kim SW, Nam EJ, Kim S, Kim HJ, Kim YT (2014) Surgical outcomes of robotic radical hysterectomy using three robotic arms versus conventional multiport laparoscopy in patients with cervical cancer. Yonsei Med J 55:1222–1230

    Article  PubMed  PubMed Central  Google Scholar 

  23. Magrina JF, Kho RM, Weaver AL, Montero RP, Magtibay PM (2008) Robotic radical hysterectomy: comparison with laparoscopy and laparotomy. Gynecol Oncol 109:86–91

    Article  Google Scholar 

  24. Asciutto KC, Kalapotharakos G, Lofgren M, Hogberg T, Borgfeldt C (2015) Robot-assisted surgery in cervical cancer patients reduces the time to normal activities of daily living. Acta Obstet Gynecol Scand 94:260–265

    Article  PubMed  Google Scholar 

  25. Bovonratwet P, Webb ML, Ondeck NT, Lukasiewicz AM, Cui JJ, McLynn RP, Grauer JN (2017) Definitional differences of ‘outpatient’ versus ‘inpatient’ THA and TKA can affect study outcomes. Clin Orthop Relat Res 475:2917–2925

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nezhat F (2008) Minimally invasive surgery in gynecologic oncology: laparoscopy versus robotics. Gynecol Oncol 111:S29–S32

    Article  PubMed  Google Scholar 

  27. Zanagnolo V, Garbi A, Achilarre MT, Minig L (2017) Robot-assisted surgery in gynecologic cancers. J Minim Invasive Gynecol 24:379–396

    Article  PubMed  Google Scholar 

  28. Kruijdenberg CB, van den Einden LC, Hendriks JC, Zusterzeel PL, Bekkers RL (2011) Robot-assisted versus total laparoscopic radical hysterectomy in early cervical cancer, a review. Gynecol Oncol 120:334–339

    Article  CAS  PubMed  Google Scholar 

  29. Reynisson P, Persson J (2013) Hospital costs for robot-assisted laparoscopic radical hysterectomy and pelvic lymphadenectomy. Gynecol Oncol 130:95–99

    Article  PubMed  Google 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 25:1102–1108

    Article  PubMed  Google Scholar 

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Acknowledgements

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.

Author information

Author notes

  1. Liangliang Han and Peijing Yan are co-first authors.

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Gansu Provincial Hospital, No. 204, West Donggang Road, Lanzhou, 730000, People’s Republic of China

    Liangliang Han, Jian Liu, Xiaohong Chen & Hailin Wang

  2. Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, People’s Republic of China

    Liangliang Han, Ruixue Shao & Hailin Wang

  3. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, West Donggang Road, Lanzhou, 730000, People’s Republic of China

    Liangliang Han & Kehu Yang

  4. Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, People’s Republic of China

    Liangliang Han, Peijing Yan, Liang Yao & Kehu Yang

  5. The Second Department of Hepatobiliary surgery, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China

    Rong Liu

  6. Department of Clinical Medicine, Lanzhou University, Lanzhou, 730000, People’s Republic of China

    Liuli Wang

  7. Department of General Surgery, Gansu Provincial Hospital, No. 204, West Donggang Road, Lanzhou, 730000, People’s Republic of China

    Tiankang Guo

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  1. Liangliang Han
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Contributions

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.

Corresponding authors

Correspondence to Kehu Yang, Tiankang Guo or Hailin Wang.

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Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

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

Informed consent was obtained from all individual participants.

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Han, L., Yan, P., Yao, L. et al. Safety and effectiveness of robotic hysterectomy versus conventional laparoscopic hysterectomy in patients with cervical cancer in China. Arch Gynecol Obstet 300, 153–160 (2019). https://doi.org/10.1007/s00404-019-05148-2

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  • DOI: https://doi.org/10.1007/s00404-019-05148-2

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