Laparoscopy versus laparotomy for the management of early stage endometrial cancer

Galaal, Khadra; Bryant, Andrew; Fisher, A; Al-Khaduri, Maha; Kew, Fiona; Lopes, Alberto

doi:10.1002/14651858.cd006655.pub2

Cited by 192 publications

(151 citation statements)

References 41 publications

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“…Endometrial cancer is the most common gynecologic cancer treated with laparoscopic surgery. It is feasible and has less operative morbidity, less blood loss, shorter hospitalizations, and better short-term quality of life than the laparotomy approach (Kornblith et al, 2009;Galaal et al, 2012;Wang et al, 2013). Similar results were reported for laparoscopic radical hysterectomy in cervical cancer (Magrina et al, 2008).…”

Section: Introductionsupporting

confidence: 57%

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Manchana

Sirisabya²,

Vasuratna³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To determine surgical outcomes, perioperative complications, and patient outcomes in gynecologic cancer patients undergoing robotic surgery. Materials and Methods: Surgical outcomes, including docking time, total operative time, console time, estimated blood loss (EBL), conversion rate and perioperative complications were retrospectively reviewed in 30 gynecologic cancer patients undergoing robotic surgery. Patient outcomes included recovery time and patient satisfaction, as scored by a visual analogue scale (VAS) from 0-10. Results: The operations included 24 hysterectomies with pelvic lymphadenectomy (PLD) and/or para-aortic lymphadenectomy, four radical hysterectomies with PLD, and two radical trachelectomies with PLD. Mean docking time was 12.8±9.7 min, total operative time was 345.5±85.0 min, and console time was 281.9±78.6 min. These times were decreased in the second half of the cases. There was no conversion rate. Three intraoperative complications, including one external iliac artery injury, one bladder injury, and one massive bleeding requiring blood transfusion were reported. Postoperative complications occurred in eight patients, most were minor. Only one patient had port herniation that required reoperation. Mean hospital stay was 3.5±1.7 days, and recovery time was 14.2±8.1 days. Two-thirds of patients felt very satisfied and one-third felt satisfied; the mean satisfaction score was 9.4 +0.9. Two patients with stage III endometrial cancer developed isolated port site metastasis at five and 13 months postoperatively. Conclusions: Robotic surgery for gynecologic cancer appears to be feasible, with acceptable perioperative complication rate, fast recovery time and high patient satisfaction.

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Section: Introductionsupporting

confidence: 57%

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Manchana

Sirisabya²,

Vasuratna³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Even though, less invasive approaches such as laparoscopic or vaginal procedures are suggested primarily, the standard procedure for most cases is abdominal hysterectomy [7,8]. The major causes for counselling vaginal or laparoscopic hysterectomy over the abdominal method is earlier beginning of routine actions, shorter hospital stay, fewer bleeding, and fewer infections.…”

Section: Introductionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

2018

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Objectives: In the present study, we aimed to compare the postoperative compliance and complications between ERAS and conventional postoperative care in patients undergoing abdominal hysterectomies. Material and methods:This is the prospective, randomized, controlled trial, which involved 62 patients, who underwent abdominal hysterectomy between December 2016 to February 2017. A total of 30 patients formed the ERAS group. A total of 32 patients who received conventional perioperative care and matched for age, body mass index (BMI) and American Society of Anesthesiologists score were assigned as a control group. Groups were compared in terms of patient characteristics [age, body mass index, ASA Score, parity, diagnosis, type of surgery, and perioperative intravenous fluids], postoperative compliance (postoperative intravenous fluids, time to first flatus, first defecation, ambulation, eating solid food, and postoperative hospital stay), and postoperative complications.Results: Peri-and post-operative administrated intravenous fluids were significantly lower in the ERAS group (p < 0.001 for both). Time to first flatus (p = 0.001), time to first defecation (p < 0.001), and time to eating solid food (p < 0.001) were all significantly shorter in the ERAS group. Post-operative early mobilization on the first postoperative day was achieved in eight (26.7%) patients in the ERAS group. There were no significant differences in complications. One (3.3%) patient in the ERAS Group and 11 (34.4%) patients in the Conventional Group required hospital readmission after discharge (p = 0.002). Conclusion:The ERAS protocol seems to be a simple tool for reducing the incidence of postoperative complications and shortening hospitalization.

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“…Minimally invasive surgery in these women has already resulted in shorter length of stay and less complications. 3 Recent studies have shown the benefit of introducing a robotic service in primary surgery for endometrial cancer, showing less conversions to laparotomy and a reduction in the number of laparotomies performed. 4,5 Obesity is one of the comorbidities related to an increase in operating time, complications, and length of stay.…”

Section: Introductionmentioning

confidence: 99%

“…There is clear evidence from both individual randomized controlled studies and a respected meta-analysis 3 that some form of laparoscopic approach is associated with less complications and a similar survival. Therefore, laparotomy is no longer the preferred route for endometrial cancer in women who are not contraindicated to have some form of laparoscopic approach.…”

mentioning

confidence: 99%

The effect of obesity on clinical and economic outcomes in robotic endometrial cancer surgery

Ind

Marshall

Hacking

et al. 2017

RSRR

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Abstract:The aim of this study was to compare the financial and clinical outcomes in roboticassisted laparoscopic surgery for primary endometrial cancer between obese and nonobese women. The hospital finance department assessed the total admission costs for robotic surgery for endometrial cancer in 54 women. This included a subanalysis for costs over nine areas (ward and clinics, drugs and pharmacy, medical staff, theaters, blood products, imaging, pathology, rehabilitation therapy, and high dependency costs). Furthermore, a prospective collection of morbidity and surgical outcome data was performed. The study group included 21 nonobese and 33 obese women (body mass index >30). Obese women were more likely to stay for more than one night in hospital (20/ ). There were six Clavien-Dindo grade II complications in the obese group and two in the nonobese group. The average overall costs were £1,852 greater (95% CI £431-£3,277, P=0.012) in the obese group. Diabetes and hypertension were associated with increased costs, but obesity was the only independent variable. In conclusion, greater resource should be allocated to obese women undergoing primary surgery for endometrial cancer.

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Laparoscopy versus laparotomy for the management of early stage endometrial cancer

Cited by 192 publications

References 41 publications

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

The effect of obesity on clinical and economic outcomes in robotic endometrial cancer surgery

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