DOI QR코드

DOI QR Code

Comparison of Perioperative and Oncologic Outcomes with Laparotomy, and Laparoscopic or Robotic Surgery for Women with Endometrial Cancer

  • Manchana, Tarinee (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University) ;
  • Puangsricharoen, Pimpitcha (Faculty of Medicine, Chulalongkorn University) ;
  • Sirisabya, Nakarin (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University) ;
  • Worasethsin, Pongkasem (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University) ;
  • Vasuratna, Apichai (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University) ;
  • Termrungruanglert, Wichai (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University) ;
  • Tresukosol, Damrong (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulalongkorn University)
  • 발행 : 2015.08.03

초록

Purpose: To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treated with laparotomy, and laparoscopic or robotic surgery. Materials and Methods: Endometrial cancer patients who underwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperative outcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intra and postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival (OS) were compared. Results: Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28 robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, p<0.05) while the robotic group had the longest operative time (302 min) as compared with laparoscopy (180 min) and laparotomy (125 min) (p<0.05). Intra and postoperative complications were not different with any of the surgical approaches. No significant difference in number of lymph nodes retrieved was identified. The longest hospital stay was reported in the laparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic (three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p =0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among the three groups. Conclusions: Minimally invasive surgery has more favorable outcomes, including lower blood loss, shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complications and short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer.

키워드

참고문헌

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피인용 문헌

  1. Robot-assisted surgery versus conventional laparoscopic surgery for endometrial cancer: a systematic review and meta-analysis vol.142, pp.10, 2016, https://doi.org/10.1007/s00432-016-2180-x
  2. Evidence for the use of robotically assisted surgery in gynecologic cancers vol.28, pp.5, 2016, https://doi.org/10.1097/CCO.0000000000000315
  3. A comparison of operative outcomes between standard and robotic laparoscopic surgery for endometrial cancer: A systematic review and meta-analysis vol.13, pp.4, 2017, https://doi.org/10.1002/rcs.1851
  4. Minimally Invasive Surgery to Treat Gynecological Cancer vol.27, pp.3, 2017, https://doi.org/10.1097/IGC.0000000000000925
  5. A Comparison of Outcomes Between Open Hysterectomy and Robotic-Assisted Hysterectomy for Endometrial Cancer Using the National Cancer Database vol.27, pp.7, 2017, https://doi.org/10.1097/IGC.0000000000001034