Prospective cohort study comparing quality of life and sexual health outcomes between women undergoing robotic, laparoscopic and open surgery for endometrial cancer

Ferguson, Sarah E.; Panzarella, Tony; Lau, Susie; Gien, Lilian T.; Samouëlian, Vanessa; Giede, Christopher; Steed, Helen; Le, Tien; Renkosinski, B.; Bernardini, Marcus Q.

doi:10.1016/j.ygyno.2018.04.558

Cited by 55 publications

(44 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other trials conducted as single arm studies on HRQoL in robotic surgery for endometrial cancer showed similar outcomes as our trial, with decreased quality of life and negatively affected postoperative symptoms one week after robotic surgery compared to baseline and a return to the preoperative level within five or six weeks after surgery (Arms, et al 2015, Herling, et al 2016a. Ferguson et al investigated prospectively HRQoL between laparoscopic, robotic and open surgery for endometrial cancer and showed similar results as those presented in our study, with improved HRQoL three weeks postoperatively for minimally invasive surgery compared to open surgery (Ferguson, et al 2018). In contrary to our trial, that study was not performed in an ERAS programme and the mean EQ-5D index was not adjusted for postoperative complications, which seem to have a substantial impact on the outcomes.…”

Section: Hrqol and Postoperative Symptomssupporting

confidence: 87%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

View full text Add to dashboard Cite

Objectives: The overall purpose of this thesis was to find medical and surgical treatment methods of improving the perioperative care of gynaecological cancer patients. The specific objectives were to determine whether a single dose tranexamic acid given immediately before surgery for presumed advanced ovarian cancer reduces perioperative blood loss and the need for blood transfusions, and to determine whether postoperative recovery, tissue damage, and inflammatory response markers differ between women operated with robotic and abdominal hysterectomy for low-risk endometrial cancer in an enhanced recovery after surgery (ERAS) programme, and to evaluate costs for hospital stay and postoperative recovery in relation to health impact. Material and Methods: The thesis was based on two randomised trials. The first trial was a randomised double-blind placebo-controlled multicentre study conducted in four hospitals in the southeast and central of Sweden between March 2008 and May 2012. One hundred women with presumed advanced ovarian cancer who had been scheduled for radical debulking surgery were included; 50 received tranexamic acid and 50 received a placebo. The main outcomes were blood loss and red blood cell transfusions. The second trial was a randomised open single centre trial at a Swedish university hospital, which included 50 women with low-risk endometrial cancer scheduled for radical surgery between February 2012 and May 2016; 25 women underwent robotic hysterectomy and 25 had abdominal hysterectomy. Anaesthesia and perioperative care followed an ERAS protocol in both groups. The EuroQol Group form EQ-5D-3L and the Short Form-36 evaluated the health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms perioperatively until six weeks postoperatively. Venous blood samples were collected on several occasions until six weeks postoperatively and were analysed for markers reflecting inflammatory response and tissue damage. In addition, a health-economy analysis was conducted comparing total costs, quality-adjusted life years (QALYs) and cost per QALY between the surgical methods. Results: Total blood loss volume and transfusion rate following surgery in advanced ovarian cancer were significantly lower in the tranexamic group compared with the placebo group. Women with early endometrial cancer treated by robotic hysterectomy recovered significantly faster in the EQ-5D health index, and reached their preoperative level nearly two weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) comprising general health and social functioning were more favourable in the robotic hysterectomy group. Consumption of analgesics, pain intensity, postoperative symptom sum score and length of hospital stay were equal between the groups. The occurrence of complications was an independent risk factor and influenced most of the outcome measures adversely. Postoperative inflammatory response and tissue damage were lower after roboti...

show abstract

Section: Hrqol and Postoperative Symptomssupporting

confidence: 87%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

View full text Add to dashboard Cite

show abstract

“…Several studies have shown the adequacy and safety of minimally invasive surgery (MIS) to perform systematic AL, with the advantages of: less postoperative pain; lower incidence of intraoperative and postoperative complications; shorter hospital stay; and improved quality of life …”

Section: Introductionmentioning

confidence: 99%

“…postoperative complications; shorter hospital stay; and improved quality of life. 6,[9][10][11][12] In recent years, robotic technology has further increased the spread of minimally invasive surgery, and many studies have emphasized its safety and further advantages in carrying out some of the most complex surgical procedures. [13][14][15][16][17][18] The main characteristics of robotic technology that facilitate surgical performances also help to shorten the learning curve, including three-dimensional visualization, articulated instrumentation, and stability of the camera.…”

mentioning

confidence: 99%

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

Gallotta

Federico

Gaballa

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objective This study aims to investigate the surgical outcomes observed in robotic transperitoneal aortic lymphadenectomy (AL) in gynecological cancer patients. Methods Retrospective data were collected and analyzed on 71 patients undergoing robotic surgical procedures for gynecological cancers, including transperitoneal AL, between December 2014 and February 2018 at the Catholic University of the Sacred Heart, Rome, Italy. Results Median age of the sample population was 50 years (range, 26‐76 years). The median operative time was 210 minutes (range, 75‐480 minutes), the median estimated blood loss was 50 ml (range, 20‐300 ml). The number of para‐aortic nodes removed was 12 (range, 7‐43). In the whole series, 13 patients (18.3%) had at least one metastatic node. Overall, 10 patients (14.1%) experienced any grade early postoperative complications. Three patients experienced more than one complication. Three intraoperative complications occurred with two cases of vascular injury. Conversion to laparotomy was necessary for one patient (1.4%). Conclusions The present study shows the safety and adequacy of robotic transperitoneal AL as surgical staging step for gynecological cancers in terms of perioperative and postoperative outcomes.

show abstract

“…This may indicate the positive effect of using the enhanced recovery after surgery protocol on post-operative recovery 24. Length of stay and time to meet the discharge criteria were equally short in both groups, showing a difference between medical discharge criteria and context-specific social circumstances or demography prolonging hospital stay.…”

Section: Discussionmentioning

confidence: 91%

A prospective randomized assessment of quality of life between open and robotic hysterectomy in early endometrial cancer

Lundin

Wodlin

Nilsson³

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectiveThere are limited prospective data on the evaluation of quality of life in patients undergoing robotic hysterectomy for endometrial cancer. Our objective was to determine whether post-operative recovery differs between robotic and abdominal hysterectomy.MethodsAt a Swedish tertiary referral university hospital, 50 women with low-risk endometrial cancer scheduled for surgery between February 2012 and May 2016 were included in a randomized trial. Surgery was performed according to principles for minimal invasive surgery. Anesthesia and peri-operative care followed a standardized enhanced recovery after surgery program in both groups. The EuroQol Group form EQ-5D and the Short Form-36 were used to evaluate patients' health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms pre-operatively, daily for 7 days from the day of surgery, and then weekly until 6 weeks post-operatively. Data were analyzed by means of non-parametric tests and repeated measures ANOVA. To evaluate the time-dependent occurrence of complications, Kaplan-Meier survival and Cox proportional-hazard models were used.ResultsA total of 50 women were enrolled in the study (25 robotic and 25 abdominal hysterectomy). Median age (68 years vs 67 years), estimated blood loss (50 mL vs 50 mL), length of hospital stay de facto (53 hours vs 51 hours), and time to meet discharge criteria (36 hours vs 36 hours) in the robotic and abdominal groups, respectively, did not differ significantly (p>0.05) Women in the robotic hysterectomy group recovered significantly faster (p=0.01) in the EQ-5D health index, and reached their pre-operative level after approximately 3 weeks, nearly 2 weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) were statistically significant in general health and social functioning only, and were in favor of robotic hysterectomy. Consumption of analgesics, pain intensity, and symptom sum score post-operatively were equal. Occurrence of complications was an independent risk factor and influenced significantly the EQ-5D health index, length of hospital stay, pain intensity, opioid consumption, and symptom sum score adversely.ConclusionRobotic hysterectomy in the setting of an enhanced recovery after surgery program led to faster recovery in health-related quality of life compared with abdominal hysterectomy.

show abstract

Prospective cohort study comparing quality of life and sexual health outcomes between women undergoing robotic, laparoscopic and open surgery for endometrial cancer

Cited by 55 publications

References 29 publications

On Quality Improvement in Gynaecological Cancer Surgery

On Quality Improvement in Gynaecological Cancer Surgery

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

A prospective randomized assessment of quality of life between open and robotic hysterectomy in early endometrial cancer

Contact Info

Product

Resources

About