Aim: We compared the short-term outcomes between conventional laparoscopic surgery (CLS) and robotassisted surgery (RAS) to assess the technical feasibility of the latter for early-stage endometrial cancer. Methods: We retrospectively compared the perioperative outcomes between two groups of 223 patients (CLS group, n = 102; RAS group, n = 121) with early-stage endometrial cancer. Surgical procedures included hysterectomy, bilateral salpingo-oophorectomy and retroperitoneal lymphadenectomy. We analyzed the data from intrapelvic surgery alone because para-aortic lymphadenectomy was performed via conventional endoscopic extraperitoneal approach without robot for both groups. Results: No differences were identified in patients' age and body mass index. The mean operative time was 133 AE 28 versus 178 AE 41 min (P < 0.01), mean blood loss was 196 AE 153 versus 237 AE 146 mL (P = 0.047), mean length of postoperative hospital stay was 9 AE 4 versus 8 AE 3 days (P = 0.01) and mean rate of perioperative complications of Clavien-Dindo grade III or higher was 2.0 versus 3.4% (P = 0.53) for the CLS versus RAS groups, respectively. There was no significant difference in the number of resected lymph nodes.
Conclusion:The operative time was significantly longer and blood loss was significantly greater in the RAS group than in the CLS group, without a significant difference in the number of resected lymph nodes. These differences are within an acceptable clinical range, showing that RAS is feasible and safe for early-stage endometrial cancer, providing short-term outcomes comparable to those of conventional surgery. Future studies are warranted to compare the long-term oncological outcomes by extending the observation period and including para-aortic lymphadenectomy data.