Abstract
Few studies have compared the efficacy of robot-assisted, laparoscopic, and open surgeries for endometrial cancer. When considering the position of robotic surgery in Japan, it was necessary to determine whether it was effective or not. We aimed to compare the efficacy and safety of these three types of surgeries for early-stage endometrial cancer. In total, 175 patients with endometrial cancer of preoperative stage IA, who had undergone laparotomic (n = 80), laparoscopic (n = 40), or robot-assisted (n = 55) modified radical hysterectomy at our hospital from 2010 to 2022, were included; surgical outcomes, perioperative complications, and prognoses were compared. Total operative and console times for robot-assisted surgery between patients who did or did not undergo pelvic lymphadenectomy were assessed. The robot-assisted group had the shortest total operative time. The estimated blood loss was lower in the laparoscopic and robot-assisted groups than in the laparotomy group. In advanced postoperative stage IA cases, there were no differences in progression-free and overall survival among the three groups. In the robot-assisted group, the operative time decreased as the number of operations increased; the learning curve was reached after 10 cases each of patients with and without pelvic lymphadenectomy. The frequency of perioperative complications of Clavien–Dindo classification Grade 1 or higher was the lowest in the robot-assisted group (p = 0.02). There were no complications of Clavien–Dindo classification Grade 2 or higher in the robot-assisted group. Robot-assisted surgery for stage IA endometrial cancer, a minimally invasive procedure, has fewer operative times and complications than those of laparoscopic and open surgeries in a single institution in Japan.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available on request from the corresponding author.
References
Nevis IF, Vali B, Higgins C, Dhalla I, Urbach D, Bernardini MQ (2017) Robot-assisted hysterectomy for endometrial and cervical cancers: a systematic review. J Robot Surg 11:1–16. https://doi.org/10.1007/s11701-016-0621-9
Barraez D, Godoy H, McElrath T, Kredentser D, Timmins P (2015) Low incidence of port-site metastasis after robotic assisted surgery for endometrial cancer staging: descriptive analysis. J Robot Surg 9:91–95. https://doi.org/10.1007/s11701-014-0491-y
Ran L, Jin J, Xu Y, Bu Y, Song F (2014) Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: a meta-analysis. PLoS ONE 26(9):e108361. https://doi.org/10.1371/journal.pone.0108361
Estape R, Lambrou N, Estape E, Vega O, Ojea T (2012) Robotic-assisted total laparoscopic hysterectomy and staging for the treatment of endometrial cancer: a comparison with conventional laparoscopy and abdominal approaches. J Robot Surg 6:199–205. https://doi.org/10.1007/s11701-011-0290-7
Mourits MJ, Bijen CB, Arts HJ et al (2010) Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomized trial. Lancet Oncol 11:763–771. https://doi.org/10.1016/S1470-2045(10)70143-1
Fu H, Zhang J, Zhao S, He N (2023) Survival outcomes of robotic-assisted laparoscopy versus conventional laparoscopy and laparotomy for endometrial cancer: a systematic review and meta-analysis. Gynecol Oncol 174:55–67. https://doi.org/10.1016/j.ygyno.2023.04.026
Holloway RW, Ahmad S, DeNardis SA et al (2009) Robotic-assisted laparoscopic hysterectomy and lymphadenectomy for endometrial cancer: analysis of surgical performance. Gynecol Oncol 115:447–452. https://doi.org/10.1016/j.ygyno.2009.08.017
Lim PC, Kang E, Park DH (2010) Learning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer. J Minim Invasive Gynecol 17:739–748. https://doi.org/10.1016/j.jmig.2010.07.008
Lim PC, Kang E, Park DH (2010) A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol 120:413–418. https://doi.org/10.1016/j.ygyno.2010.11.034
Zhang N, Wilson B, Enty MA et al (2022) Same-day discharge after robotic surgery for endometrial cancer. J Robot Surg 16:543–548. https://doi.org/10.1007/s11701-021-01253-0
Raffone A, Travaglino A, Raimondo D et al (2022) Laparotomic versus robotic surgery in elderly patients with endometrial cancer: a systematic review and meta-analysis. Int J Gynaecol Obstet 157:1–10. https://doi.org/10.1002/ijgo.13766
Corrado G, Vizza E, Perrone AM et al (2021) Comparison between laparoscopic and robotic surgery in elderly patients with endometrial cancer: a retrospective multicentric study. Front Oncol 11:724886. https://doi.org/10.3389/fonc.2021.724886
Uwins C, Hablase R, Assalaarachchi H et al (2022) Enhanced recovery after uterine corpus cancer surgery: a 10 year retrospective cohort study of robotic surgery in an NHS cancer centre. Cancers (Basel) 14:5463. https://doi.org/10.3390/cancers14215463
Acknowledgements
The authors thank all the members who responded to the questionnaires.
Funding
No funding was received for this study.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Hiroaki Komatsu]. The first draft of the manuscript was written by [Ai Ikebuchi] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there is no conflict of interest.
Ethical approval
This study was approved by the Institutional Review Board of Tottori University Hospital (IRB no. 22A134). All patients provided written informed consent following institutional guidelines. All methods were performed in accordance with relevant guidelines and regulations.
Consent to participate
All participants agreed by optout.
Consent to publish
The authors affirm that human research participants provided informed consent for publication.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Ikebuchi, A., Komatsu, H., Yamamoto, K. et al. Outcome of robot-assisted surgery for stage IA endometrial cancer compared to open and laparoscopic surgeries: a retrospective study at a single institution. J Robotic Surg 18, 133 (2024). https://doi.org/10.1007/s11701-024-01897-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11701-024-01897-8