Comparison between 155 cases of robotic vs. 150 cases of open surgical staging for endometrial cancer
2012
Abstract Objective To compare the outcomes of 155 cases of endometrial cancer who had robot-assisted surgical staging to 150 open cases. Methods Retrospective chart review of cases of endometrial cancer that underwent staging two different ways by two surgeons at an academic institution. Results Mean age was 62.4years in the robotic arm and 65 ( P =0.04) in the open arm. Mean body mass index was 34.5Kg/m 2 in the robotic arm and 33Kg/m 2 in the open arm ( P =0.2). Pelvic and para-aortic lymph node dissection were performed in 94.8% and 67.7% of the robotic cases versus 95.3% and 74% of the open cases, respectively. Mean operative time was 127min in the robotic arm, and 141min in the open arm ( P =0.0001). Mean lymph node count was 20.3 in the robotic arm, and 20 in the open arm ( P =0.567). Mean estimated blood loss was 119ml in the robotic arm and 185 in the open arm ( P =0.015). Mean hospital stay was 1.5days in the robotic arm, and 4days in the open arm ( P =0.0001). The incidence of postoperative ileus (0.6% vs. 10.7%, P=0.0001), infections (5.2% vs. 24%, P =0.0001), anemia/transfusion (1.3% vs. 7.7%, P =0.005), and cardiopulmonary complications (3.2% vs.14.7%, P =0.003) was significantly lower in the robotic arm vs. the open arm. There was one death in the robotic arm attributed to pre-existing cardiac condition. Conclusion Robotic-assisted staging reaps the benefits of minimally invasive surgery without compromising the adequacy of the procedure. Dedication to the technique shortens the operative time.
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