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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Coronado, Pluvio J. Herraiz, Miguel A. Magrina, Javier F. Fasero, María Vidart, Jose A. |
| Description | Country affiliation: Spain Author Affiliation: Coronado PJ ( Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Spain. pcoronadom@sego.es) |
| Abstract | OBJECTIVE: To analyze the perioperative outcomes and cost of three surgical approaches in the treatment of endometrial cancer: robotic, laparoscopy and laparotomy. STUDY DESIGN: We studied 347 patients with endometrial cancer treated in a single institution: 71 patients were operated by robotics, 84 by conventional laparoscopy and 192 by laparotomy. All patients underwent total hysterectomy, bilateral salpingoophorectomy and pelvic and para-aortic lymphadenectomy depending on the pathological features. RESULTS: Operative time was longer in the laparoscopy group as compared to robotics and laparotomy (218.2 min, 189.2 min, and 157.4 min respectively, p=0.000). The estimated blood loss was lower in the robotic group relative to the other groups (99.4 ml in robotic, 190.0 ml in laparoscopy and 231.5 ml in laparotomy, p=0.000). Similar findings were observed for the pre- and post-operative mean hemoglobin levels (-1.3g/dl, -2.3g/dl and -2.5 g/dl respectively, p=0.000), and transfusion rate (4.2%, 7.1% and 14.1% respectively, p=0.036). The length of hospital stay was higher in the laparotomy group compared to robotics and laparoscopy (8.1, 3.5 and 4.6 days respectively; p=0.000). The conversion rate to laparotomy was lower for robotics (2.4% for robotics and 8.1% for laparoscopy, p=0.181). Overall complications were similar for robotics and laparoscopy (21.1%, 28.5%) (p=0.079). Robotic complications were significantly lower as compared to laparotomy (21.2 vs 34.9% (p=0.036). No differences were found relative to disease-free or overall survival among the three groups. The global costs were similar for the three approaches (p=0.566). CONCLUSION: Robotics is a safe alternative to laparoscopy and laparotomy for endometrial cancer patients, offering improved perioperative outcomes and similar cost as compared to the other two surgical approaches. |
| File Format | HTM / HTML |
| ISSN | 03012115 |
| Issue Number | 2 |
| Volume Number | 165 |
| e-ISSN | 18727654 |
| Journal | European Journal of Obstetrics & Gynecology and Reproductive Biology |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2012-12-01 |
| Publisher Place | Ireland |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Obstetrics Discipline Gynecology Endometrial Neoplasms Surgery Laparoscopy Economics Laparotomy Robotics Aged Cost-benefit Analysis Female Humans Hysterectomy Adverse Effects Length Of Stay Middle Aged Journal Article |
| Content Type | Text |
| Resource Type | Article |
| Subject | Reproductive Medicine Obstetrics and Gynecology |
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