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Robotic Surgery Works for Staging Endometrial Ca


 

Major Finding: Robotic surgery was associated with significantly less blood loss and shorter hospital stays than laparotomy for the surgical staging of endometrial cancer.

Data Source: A retrospective study of 97 patients.

Disclosures: None reported.

KISSIMMEE, Fla. — Robotic laparoscopic surgery is an acceptable alternative to laparotomy for the surgical staging of endometrial cancer, based on results of a retrospective study of 97 patients.

While node retrieval numbers were similar for the two procedures, robotic surgery was associated with significantly less blood loss and shorter hospital stays. Moreover, patients undergoing robotic surgery had fewer intraoperative complications, despite being significantly more overweight than those undergoing laparotomy, Dr. Meenu Goel said at the annual meeting of the AAGL.

Dr. Goel of Indiana University, Indianapolis, examined outcomes for 97 patients who underwent surgical staging for endometrial cancer from 2003 to 2008. The 38 patients who had laparotomies underwent surgery from 2003 to 2005, when this was the standard approach at the hospital. From 2006 to 2008, all endometrial cancer staging was performed with robotic laparoscopy; this cohort included 59 patients.

Patients in the open surgery group were significantly older than those in the robotic surgery group (66 vs. 59 years). But those in the robotic group were significantly heavier, with a mean body mass index of 39 kg/m

Operative times were 175 vs. 185 minutes, respectively, for the open and robotic groups. The number of pelvic nodes retrieved was similar (9 in the open group vs. 11 in the robotic group), as was the number of aortic nodes (3 in the open group vs. 2 in the robotic group). Half of the patients in each group were diagnosed with stage III cancer, “probably due to the fact that we are a referral hospital,” Dr. Goel said.

The open group had a significantly longer mean hospital stay (3 days vs. 1 day).

The rate of complications was significantly less in the robotic group than in the open group (3% vs. 13%). There were two complications in the robotic group: a tear in the right external iliac vein that required open management and a transfusion, and a pelvic abscess, which was treated with postoperative antibiotics. There were five complications in the open surgery group: two cases of wound dehiscence, one intraoperative small bowel resection, one cardiac arrhythmia that required a pacemaker, and one pulmonary embolism.

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