Robotic-Assisted Radical Hysterectomy Results in Better Surgical Outcomes Compared With the Traditional Laparoscopic Radical Hysterectomy for the Treatment of Cervical Cancer

Abstract

ObjectiveThe aim of this study was to compare the surgical outcomes of robotic-assisted radical hysterectomy (RRH) with traditional laparoscopic radical hysterectomy (TLRH) for the treatment of early-stage cervical cancer in a large retrospective cohort of a total of 933 patients.MethodsWe have enrolled 100 patients into the RRH and 833 patients into the TLRH group. The surgical outcomes include operating time, blood loss, transfusion rate, pelvic lymph node yield, hospitalization days, duration of bowel function recovery, catheter removal before and after 3 weeks, conversion to laparotomy, and intraoperative and postoperative complications. Follow-up results were also analyzed for all patients.ResultsBoth groups have similar patient and tumor characteristics but patients with a larger lesion size were preferably enrolled in the TLRH treatment group. The treatment with RRH was generally superior to TLRH with respect to operating time, blood loss, length of hospitalization, duration of bowel function recovery, and postoperative complications. On follow-up of patients, there were no relapses reported in the RRH group compared with 4% of relapse cases and 2.9% of deaths because of metastasis in the TLRH group. No conversion of laparotomy occurred in the RRH group. No significant difference was found with respect to intraoperative complications and blood transfusion between both groups.ConclusionsThe results from this study suggest that RRH is superior to TLRH with regard to surgical outcome and may pose a safe and feasible alternative to TLRH. The operating time and lymph node yield is acceptable. Our study is one of the largest single-center studies of surgical outcomes comparing RRH with TLRH during cervical cancer treatment and will significantly contribute to the safety of alternative treatment options for patients. Furthermore, the difference detected between TLRH and RRH group is further strengthened by the great expertise of the surgeon performing laparoscopic surgeries.

Sexual, bladder, bowel and ovarian function 1 year after robot‐assisted radical hysterectomy for early‐stage cervical cancer

“…Retrospective and prospective studies of sexual function after open RH demonstrate impaired sexual desire, arousal, and satisfaction . In addition, urination problems and bowel dysfunction occur frequently, not only after open RH but also after laparoscopic surgery . However, few studies have investigated the effect of robot‐assisted laparoscopic radical hysterectomy (RRH) on sexual, bladder, and bowel functions.…”

Short‐term outcomes of robotic‐assisted versus conventional laparoscopic radical hysterectomy for early‐stage cervical cancer: A single‐center study

“…Of the 20 controlled studies on LRH and RARH that we identified in PubMed, up to December 2017, with ‘robot’ and ‘radical hysterectomy’ as search terms, nine studies included reports on 30 or more cases of RARH (Table ) . Generally in these studies, the volume of blood loss was smaller for RARH than LRH, with no conclusions on the relative merits in terms of short‐term perioperative outcomes.…”

“…were the first to report on robot‐assisted radical hysterectomy (RARH) with lymph node dissection, in 2006 . Since then, several studies have compared conventional laparoscopic radical hysterectomy (LRH) and RARH, with comparable short‐term outcomes having been reported for both procedures, including estimated blood loss, operative time, complications and the number of resected lymph nodes …”

Surgical and Patient Outcomes of Robotic Versus Conventional Laparoscopic Hysterectomy: A Systematic Review

“…However, RH proved to be more profitable in complex procedures, obese patients, and in uterine weights >750 g [30,31]. The price per patient is also expected to drop with increased RH use and surgeon experience [33].…”