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

Abstract

Aim: Our hospital adopted laparoscopic surgery for early-stage cervical cancer in August 1998, with robotassisted 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 AE standard deviation), results obtained were as follows: operative time, 211 AE 38/280 AE 59 min (P < 0.01); blood loss, 219 AE 114/370 AE 231 mL (P < 0.01); number of resected lymph nodes, 38.5 AE 15.9/50.2 AE 18.2 (P < 0.01); length of postoperative hospital stay, 11.6 AE 3.3/11.3 AE 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.

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

“…Minimally invasive techniques, including robotic surgery, developed rapidly because of their intraoperative and postoperative advantages with comparable survival outcomes [14,17,18]. As research advances, the conclusion that minimally invasive surgery has a better survival outcome than open surgery has not changed [19]; however, in 2017, conflicting survival data of minimally invasive radical hysterectomy began to be reported [11,20].…”

Short‐term outcomes of robot‐assisted versus conventional laparoscopic surgery for early‐stage endometrial cancer: A retrospective, single‐center study

“…In addition, the Probe Plus II, which is a suction irrigator probe with a built-in integrated monopolar electrode, was used in CLS. 26 This device makes it possible to detect bleeding points immediately and perform quick hemostasis without exchanging forceps. However, in RAS, there was no equivalent instrument.…”

“…As all surgeries in our study were performed by one experienced surgeon, the greater EBL with RAS than with CLS likely reflects the differences in instrumentation between the two approaches. In addition, the Probe Plus II, which is a suction irrigator probe with a built‐in integrated monopolar electrode, was used in CLS . This device makes it possible to detect bleeding points immediately and perform quick hemostasis without exchanging forceps.…”

Comparison Between 360° 3-D Transvaginal Ultrasound and Magnetic Resonance Imaging for Assessment of Vaginal Invasion in Cervical Cancer: A Preliminary Report

“…Compared with surgical/histological staging, the error rate of clinical staging of primary cervical cancer is between 26% and 66%, so it is difficult for clinical staging to provide precise information before surgery to guide the scope of vagina resection (Sheu et al 2001). If the postoperative vaginal margin is positive, only salvage treatment can be used, causing difficulties in clinical treatment (Oyama et al 2019).…”