A case-control study of robotic radical hysterectomy and pelvic lymphadenectomy using 3 robotic arms compared with abdominal radical hysterectomy in cervical cancer

Abstract

OBJECTIVE: The purpose of this study was to compare surgical outcomes of robotic radical hysterectomy (RRH) using 3 robotic arms with those of abdominal radical hysterectomy (ARH) in the treatment of early-stage cervical cancer.

METHODS: Thirty-two patients with stage IA2-IIB cervical carcinoma according to the International Federation of Gynecology and Obstetrics underwent RRH between June 2006 and February 2009. Patient outcomes were compared with those of a historic cohort of 32 patients who underwent ARH, who were matched for age, stage according to the International Federation of Gynecology and Obstetrics, and type of radical surgery.

RESULTS: All RRHs were completed robotically with no conversions to laparotomy. Robotic radical hysterectomy showed favorable outcomes over ARH in terms of the mean length of hospital stay (11.6 vs 16.9 days, P < 0.001) and the mean estimated blood loss (220 vs 531 mL, P = 0.002). The mean operating time and the number of lymph node retrievals were comparable. There were no significant differences in the incidence of postoperative complications between the 2 groups. The mean follow-up time was 15.3 months, and 2 patients in the RRH group had recurrences.

CONCLUSIONS: Robotic radical hysterectomy and pelvic lymphadenectomy using 3 robotic arms is feasible and preferable over ARH for the treatment of cervical cancer patients. Prospective randomized trials should be completed to confirm the potential benefits associated with RRH