Robotic Assisted, Total Laparoscopic, and Total Abdominal Hysterectomy for Management of Uterine Cancer

摘要

Objectives: The purpose was to compare robotic assisted total laparoscopic hysterectomy (TRH), laparoscopic assisted hysterectomy (TLH) and total abdominal hysterectomy (TAH) with surgical staging +/- lymphadenectomy for the management of uterine cancer. Methods: Institutional review board approval was obtained and patient characteristics, pathologic data, and data related to the surgical procedure were collected from chart review. Data were analyzed with SAS statistical software. Results: A total of 102 TRHs were compared to 115 TLHs and 79 TAHs. There were more grade I and endometrial intraepithelial (EIN) lesions in the preoperative pathology of TLHs (P P P P P P P < 0.05). Conclusion: Despite longer surgical times, benefits of minimally invasive technology included shortened length of stay, decreased wound infections, transfusions, and blood loss. In our population, procedure selection for TLH versus TRH may have been influenced by lower preoperative grade, with reservation of robotic technology for cases anticipated to be more complex, and therefore justifying increased technology costs and operating times.