A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy

• Published in: American journal of obstetrics and gynecology Vol. 199; no. 4; pp. 357.e1 - 357.e7
• Main Authors: Boggess, John F., MD, Gehrig, Paola A., MD, Cantrell, Leigh, MD, Shafer, Aaron, MD, Ridgway, Mildred, MD, Skinner, Elizabeth N., MD, Fowler, Wesley C., MD
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.10.2008; Elsevier
• Subjects: Adenocarcinoma - surgery; Adult; Biological and medical sciences; Carcinoma, Squamous Cell - surgery; Case-Control Studies; cervical cancer; da Vinci Surgical System; Female; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - methods; laparoscopy; Lymph Node Excision; Medical sciences; Obstetrics and Gynecology; Pregnancy; radical hysterectomy; robotic technology; Robotics; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Treatment Outcome; Uterine Cervical Neoplasms - surgery; laparoscopy; radical hysterectomy; cervical cancer; robotic technology; da Vinci Surgical System; Treatment; Pelvic cavity; Lymph node; Surgery; Gynecology; Case control study; Hysterectomy; Dissection; Obstetrics; Radical; Comparative study
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.06.058

Objective The purpose of this study was to compare robotically assisted hysterectomy (RAH) with open (ORH) type III radical hysterectomy in the treatment of early-stage cervical cancer. Study Design The outcomes of 51 consecutive patients who underwent RAH were compared with the outcomes of 49 patients who underwent ORH. Results There were no differences with regard to patient demographics. There were significant differences between the groups with regard to operative blood loss ( P < .0001), operative time ( P = .0002), and lymph node retrieval ( P = .0003), all of which were in favor of the RAH cohort. All patients with RAH were discharged on postoperative day 1, compared with a 3.2-day average hospitalization for the cohort with ORH. The incidence of postoperative complications was 7.8% and 16.3% for the RAH and ORH cohorts, respectively ( P = .35). Conclusion Robotic type III radical hysterectomy with pelvic node dissection is feasible and may be preferable over open radical hysterectomy in patients with early-stage cervical cancer. Further study will determine procedure generalizability and long-term oncologic outcomes.