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Short‐term outcomes of robotic‐assisted versus conventional laparoscopic radical hysterectomy for early‐stage cervical cancer: A single‐center study
Author(s) -
Oyama Keisuke,
Kanno Kiyoshi,
Kojima Ryuji,
Shirane Akira,
Yanai Shiori,
Ota Yoshiaki,
Andou Masaaki
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13858
Subject(s) - medicine , radical hysterectomy , perioperative , cervical cancer , blood loss , stage (stratigraphy) , surgery , lymphadenectomy , lymph , body mass index , laparoscopy , cancer , paleontology , psychiatry , biology
Aim Our hospital adopted laparoscopic surgery for early‐stage cervical cancer in August 1998, with robot‐assisted surgery implemented in October 2013. This study aimed to compare short‐term outcomes for conventional laparoscopic radical hysterectomy (LRH) and robot‐assisted radical hysterectomy (RARH) and assess the technical feasibility of RARH for early‐stage cervical cancer. Methods We retrospectively compared operative time, blood loss, number of resected lymph nodes, length of postoperative hospital stay, rate of positive vaginal margin and perioperative complications between two groups of 121 patients (LRH group, n = 57; RARH group, n = 64) with stage IA2 to IIB, among 164 patients who underwent endoscopic radical hysterectomy for early‐stage cervical cancer performed between January 2010 and December 2017 by an expert surgeon, excluding cases of para‐aortic lymphadenectomy. Results No differences in patient background, in terms of age and body mass index, were identified. For the LRH/RARH groups (mean ± standard deviation), results obtained were as follows: operative time, 211 ± 38/280 ± 59 min ( P < 0.01); blood loss, 219 ± 114/370 ± 231 mL ( P < 0.01); number of resected lymph nodes, 38.5 ± 15.9/50.2 ± 18.2 ( P < 0.01); length of postoperative hospital stay, 11.6 ± 3.3/11.3 ± 4.8 days ( P = 0.67); and perioperative complications with Clavien‐Dindo classification of grade III or higher, 1.8/7.8% ( P = 0.13). Conclusion The operative time was significantly longer and blood loss greater in the RARH than LRH group. A greater number of lymph nodes were removed in the RARH group. However, these differences seem to be within a clinically acceptable range, showing that RARH is as feasible and safe as LRH in terms of short‐term outcomes.