Minimally Invasive Techniques for Treating Gynecologic Malignancies

Fader, Amanda N.

doi:10.6004/jnccn.2017.0086

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Despite level-one evidence showing advantages of minimally invasive hysterectomy over laparotomy, scant data compare outcomes between different MIGS [5,11,12]. Currently, gynecologists choose the surgical approach based on their personal preference [2].…”

Section: Introductionmentioning

confidence: 99%

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

Alshowaikh¹,

Karpinska-Leydier²,

Amirthalingam³

et al. 2021

Cureus

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Hysterectomy is a commonly performed gynecologic surgery that can be associated with significant morbidity and mortality. However, the evolution of the surgical approach, from open to minimally invasive gynecologic surgery (MIGS), has substantially improved patient outcomes by reducing perioperative complications, pain, and length of hospitalization. The evident advantages and the approval of the da Vinci Surgical System by the Food and Drug Administration led to the exponential rise in the use of MIGS. In particular, robotic hysterectomy (RH) witnessed unparalleled popularity compared to other MIGS despite the lack of strong evidence demonstrating its superiority. Therefore, we conducted a systematic review of the literature to evaluate and compare various patient and surgical outcomes of RH with conventional laparoscopic hysterectomy (CLH), including operating time, estimated blood loss, length of hospitalization, overall complications, survival, and cost. Overall, the outcomes were comparable between RH and CLH except concerning cost. RH is significantly more expensive than CLH due to the higher costs of robotic equipment, including disposable instruments, equipment maintenance, and sterilization. Although RH demonstrated comparable outcomes and higher costs, its technical advantages such as improved ergonomics, three-dimensional view, a wider range of wristed mobility, mechanical lifting of robot's hand, and greater stability might benefit patient subsets (e.g., obesity, large uterine weights >750 g). Therefore, large and multicentered randomized control trials are imperative to determine the most effective surgical approach between RH and other MIGS for different patient subsets.

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Section: Introductionmentioning

confidence: 99%

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

Alshowaikh¹,

Karpinska-Leydier²,

Amirthalingam³

et al. 2021

Cureus

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“…Surgical cytoreduction remains paramount in the treatment of early-stage and advanced endometrial cancer. MIS was approved as a quality measure by the Society of Gynecologic Oncology (SGO) in 2014 and incorporated into the National Comprehensive Cancer Network's (NCCN) guidelines in 2017 [6,7]. Globally, a recent U.S. Centers for Disease Control (CDC) study demonstrated that endometrial cancer rates increased in 26 of the 43 countries, with South Africa and several countries in Asia showing the largest increase [8].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgical access in morbidly obese women undergoing endometrial cancer surgery: Repurposing the left upper quadrant approach

Varghese

Peijnenburg²,

Stone³

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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Comparison of The Effects of Epidural Analgesia and Conventional Analgesia on Survival in Patients Undergoing Gynecological Oncological Surgery: A retrospective analysis

Aydın,

Tüten

2024

Türk Kadın Sağlığı Ve Neonatoloji Dergisi

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Purpose: We aimed to determine whether mortality due to gynecologic cancer differs in patients who received epidural analgesia versus conventional analgesia. Additionally, we aimed to investigate which analgesia approach results in a better prognosis for gynecologic cancer. Materials and Methods: Patients who underwent surgery for a gynecologic malignancy were divided into two study groups based on the type of analgesia used: the Epidural Analgesia Group (n=120) and the Conventional Analgesia Group (n=88). All data were retrospectively collected from patient case charts. Variables recorded included patients’ age, body mass index (BMI), presence of comorbid diseases, duration of anesthesia, amount of blood transfusion. During surgery, duration of hospital stay, duration of intensive care unit stay, presence of postoperative infection, and type of postoperative treatment. Results: Survival after surgery tended to be higher in patients who received conventional analgesia (81 out of 88 patients) compared to those who received epidural analgesia (102 out of 120 patients), although this difference was not statistically significant (p=0.123). After controlling for all other factors, the coefficient for blood transfusion was -0.192 with a p- value of 0.007, indicating that a lower amount of blood transfusion was associated with increased survival. Similarly, the coefficient for the presence of comorbid diseases was -0.163 with a p-value of 0.022, suggesting that fewer comorbidities contributed to better survival post-surgery. Conventional analgesia showed higher survival rates (coefficient=0.163,p=0.022) compared to epidural analgesia. None of the other variables showed a significant correlation with survival. Conclusion: This study is among the pioneering research efforts to explore the impact of analgesia methods on the prognosis of patients with non-metastatic gynecologic cancer. A lower amount of blood transfusion during surgery and fewer comorbid diseases contribute to improved survival rates.

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Minimally Invasive Techniques for Treating Gynecologic Malignancies

Cited by 3 publications

References 9 publications

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

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

Laparoscopic surgical access in morbidly obese women undergoing endometrial cancer surgery: Repurposing the left upper quadrant approach

Comparison of The Effects of Epidural Analgesia and Conventional Analgesia on Survival in Patients Undergoing Gynecological Oncological Surgery: A retrospective analysis

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