Comparison of robotic‐assisted versus laparoscopy for transperitoneal infrarenal para‐aortic lymphadenectomy in patients with endometrial cancer

摘要

Abstract Aim This study was conducted to evaluate the clinical feasibility of robotic‐assisted transperitoneal infrarenal para‐aortic lymphadenectomy ( TIPAL ) in patients with endometrial cancer. Methods From J une 2006 to O ctober 2016, we retrospectively analyzed 42 patients who underwent laparoscopic ( n ?=?16) or robotic‐assisted ( n ?=?26) staging operations, including TIPAL for endometrial cancer. Perioperative data including age; body mass index; operation duration; the number of lymph nodes retrieved and the ratio of time to lymph node retrieval during pelvic, infrarenal para‐aortic and total lymphadenectomy; estimated blood loss and postoperative complications were compared. Results The operative duration of pelvic (21.7?±?5.31 vs 30.7?±?10.8?min; P ?=?0.002), and total (62.6?±?14.0 vs 87.0?±?30.4?min; P ?=?0.010) lymphadenectomy was significantly shorter in the robotic‐assisted than the laparoscopic group, whereas there was no statistical difference in the duration of infrarenal para‐aortic lymphadenectomy. By contrast, the number of infrarenal para‐aortic lymph nodes retreived was significantly higher (29.4?±?10.7 vs 23.3?±?9.16; P ?=?0.016) in the robotic‐assisted group. Consequently, the ratio of time to number of lymph nodes retrieved during infrarenal (1.51?±?0.49 vs 2.62?±?1.34; P ?=?0.002) and total (1.43?±?0.48 vs 2.15?±?0.93; P ?=?0.014) lymphadenectomy was lower in the robotic‐assisted compared to the laparoscopic group. Conclusions The robotic‐assisted approach took less time per infrarenal para‐aortic and total lymph nodes retrieved compared to the conventional laparoscopic approach. Robotic‐assisted TIPAL could be feasible and effective for the staging and treatment of patients with endometrial cancer.