Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer
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Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer. / Herling, Suzanne Forsyth; Møller, Ann M; Palle, Connie; Grynnerup, Anja; Thomsen, Thordis.
In: Danish Medical Journal, Vol. 64, No. 3, A5343, 2017.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer
AU - Herling, Suzanne Forsyth
AU - Møller, Ann M
AU - Palle, Connie
AU - Grynnerup, Anja
AU - Thomsen, Thordis
PY - 2017
Y1 - 2017
N2 - INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes.METHODS: A non-randomised, controlled before and after study of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls).RESULTS: RALH had significant advantages compared with TAH: fewer and less severe post-operative complications and a shorter length of hospital stay. The absolute risk reduction for post-operative complications was 13% (95% confidence interval: 4.29-20.87%). Women treated with TAH had significantly more severe complications (grade ≥ 3) than those treated with RALH; 12% versus 3% (p = 0.001). Infections (urinary and port site) were the most frequent post-operative complications overall. The duration of RALH in the operation theatre was longer, while the duration of stay in the post-anaesthesia care unit was shorter for patients undergoing RALH.CONCLUSIONS: RALH appears advantageous for women treated for endometrial cancer in terms of post-operative complications. We recommend the use of the Clavien-Dindo classification of surgical outcomes for quality assessment.FUNDING: departmental only.TRIAL REGISTRATION: Danish Health Authority (3-2013-111/1/KAHO).
AB - INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes.METHODS: A non-randomised, controlled before and after study of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls).RESULTS: RALH had significant advantages compared with TAH: fewer and less severe post-operative complications and a shorter length of hospital stay. The absolute risk reduction for post-operative complications was 13% (95% confidence interval: 4.29-20.87%). Women treated with TAH had significantly more severe complications (grade ≥ 3) than those treated with RALH; 12% versus 3% (p = 0.001). Infections (urinary and port site) were the most frequent post-operative complications overall. The duration of RALH in the operation theatre was longer, while the duration of stay in the post-anaesthesia care unit was shorter for patients undergoing RALH.CONCLUSIONS: RALH appears advantageous for women treated for endometrial cancer in terms of post-operative complications. We recommend the use of the Clavien-Dindo classification of surgical outcomes for quality assessment.FUNDING: departmental only.TRIAL REGISTRATION: Danish Health Authority (3-2013-111/1/KAHO).
KW - Aged
KW - Controlled Before-After Studies
KW - Denmark
KW - Endometrial Neoplasms/surgery
KW - Female
KW - Humans
KW - Hysterectomy/adverse effects
KW - Laparoscopy/methods
KW - Length of Stay
KW - Middle Aged
KW - Postoperative Complications/diagnosis
KW - Robotic Surgical Procedures/adverse effects
M3 - Journal article
C2 - 28260596
VL - 64
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 3
M1 - A5343
ER -
ID: 194524334