A comparison of outcomes following robotic-assisted staging and laparotomy in patients with early stage endometrioid adenocarcinoma of the uterus with uterine weight under 480 g

Michael A. Ulm, Daniel N. Ginn, Adam C. ElNaggar, Todd Tillmanns, Kevin M. Reed, Jim Wan, Catherine H. Watson, Sheetal J. Dedania, Mark Reed

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Study Objective: To directly compare perioperative morbidity and hospital stay after robotic-assisted staging and laparotomy in patients with early stage endometrial endometrioid adenocarcinoma and uterine weight under 480 g. Design: Retrospective cohort study. Setting: The West Clinic in Memphis, TN, USA. Patients: Patients with Stage IA and Stage IB endometrial endometrioid adenocarcinoma and uterine weight less than 480 g from June 2007 to January 2011. Interventions: Patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection with or without para-aortic lymph node dissection using robotic-assisted surgery or open laparotomy. Measurements: Perioperative complications and morbidity, length of hospital stay, progression-free survival, overall survival, time to recurrence, and time do death from disease. Main Results: A total of 160 patients who underwent laparotomy and 165 patients who received robotic-assisted staging were identified. Compared with robotic-assisted staging, laparotomy was associated with increased hospital stay (3 days vs. 1.4 days, p < 0.001), greater estimated blood loss (237 cm3 vs. 102 cm3, p < 0.001), larger uterine weight (136 g vs. 116 g, p < 0.001), as well as higher incidence of postoperative complications [29.3% vs. 6.7%, odds ratio (OR) 5.82, 95% confidence interval (CI) 2.1-11.7] including postoperative ileus (9.0% vs. 1.0%, OR 7.82, 95% CI 1.7-35.0), wound infection (6.0% vs. 1.0%, OR 5.43, 95% CI 1.2-25.2), and postoperative atelectasis (4.0% vs. 0%, p < 0.01). There were no differences in projected 5-year progression-free and overall survival rates. Conclusion: Use of the daVinci robotic system was associated with less intraoperative blood loss, fewer postoperative complications, and shorter hospital stay compared with laparotomy for patients with uterine weight less than 480 g.

Original languageEnglish (US)
Pages (from-to)25-29
Number of pages5
JournalGynecology and Minimally Invasive Therapy
Volume5
Issue number1
DOIs
StatePublished - Feb 1 2016

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Endometrioid Carcinoma
Robotics
Laparotomy
Uterus
Weights and Measures
Length of Stay
Odds Ratio
Confidence Intervals
Lymph Node Excision
Disease-Free Survival
Morbidity
Pulmonary Atelectasis
Ileus
Ovariectomy
Wound Infection
Hysterectomy
Cohort Studies
Survival Rate
Retrospective Studies
Recurrence

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

A comparison of outcomes following robotic-assisted staging and laparotomy in patients with early stage endometrioid adenocarcinoma of the uterus with uterine weight under 480 g. / Ulm, Michael A.; Ginn, Daniel N.; ElNaggar, Adam C.; Tillmanns, Todd; Reed, Kevin M.; Wan, Jim; Watson, Catherine H.; Dedania, Sheetal J.; Reed, Mark.

In: Gynecology and Minimally Invasive Therapy, Vol. 5, No. 1, 01.02.2016, p. 25-29.

Research output: Contribution to journalArticle

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title = "A comparison of outcomes following robotic-assisted staging and laparotomy in patients with early stage endometrioid adenocarcinoma of the uterus with uterine weight under 480 g",
abstract = "Study Objective: To directly compare perioperative morbidity and hospital stay after robotic-assisted staging and laparotomy in patients with early stage endometrial endometrioid adenocarcinoma and uterine weight under 480 g. Design: Retrospective cohort study. Setting: The West Clinic in Memphis, TN, USA. Patients: Patients with Stage IA and Stage IB endometrial endometrioid adenocarcinoma and uterine weight less than 480 g from June 2007 to January 2011. Interventions: Patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection with or without para-aortic lymph node dissection using robotic-assisted surgery or open laparotomy. Measurements: Perioperative complications and morbidity, length of hospital stay, progression-free survival, overall survival, time to recurrence, and time do death from disease. Main Results: A total of 160 patients who underwent laparotomy and 165 patients who received robotic-assisted staging were identified. Compared with robotic-assisted staging, laparotomy was associated with increased hospital stay (3 days vs. 1.4 days, p < 0.001), greater estimated blood loss (237 cm3 vs. 102 cm3, p < 0.001), larger uterine weight (136 g vs. 116 g, p < 0.001), as well as higher incidence of postoperative complications [29.3{\%} vs. 6.7{\%}, odds ratio (OR) 5.82, 95{\%} confidence interval (CI) 2.1-11.7] including postoperative ileus (9.0{\%} vs. 1.0{\%}, OR 7.82, 95{\%} CI 1.7-35.0), wound infection (6.0{\%} vs. 1.0{\%}, OR 5.43, 95{\%} CI 1.2-25.2), and postoperative atelectasis (4.0{\%} vs. 0{\%}, p < 0.01). There were no differences in projected 5-year progression-free and overall survival rates. Conclusion: Use of the daVinci robotic system was associated with less intraoperative blood loss, fewer postoperative complications, and shorter hospital stay compared with laparotomy for patients with uterine weight less than 480 g.",
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AU - Ulm, Michael A.

AU - Ginn, Daniel N.

AU - ElNaggar, Adam C.

AU - Tillmanns, Todd

AU - Reed, Kevin M.

AU - Wan, Jim

AU - Watson, Catherine H.

AU - Dedania, Sheetal J.

AU - Reed, Mark

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N2 - Study Objective: To directly compare perioperative morbidity and hospital stay after robotic-assisted staging and laparotomy in patients with early stage endometrial endometrioid adenocarcinoma and uterine weight under 480 g. Design: Retrospective cohort study. Setting: The West Clinic in Memphis, TN, USA. Patients: Patients with Stage IA and Stage IB endometrial endometrioid adenocarcinoma and uterine weight less than 480 g from June 2007 to January 2011. Interventions: Patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection with or without para-aortic lymph node dissection using robotic-assisted surgery or open laparotomy. Measurements: Perioperative complications and morbidity, length of hospital stay, progression-free survival, overall survival, time to recurrence, and time do death from disease. Main Results: A total of 160 patients who underwent laparotomy and 165 patients who received robotic-assisted staging were identified. Compared with robotic-assisted staging, laparotomy was associated with increased hospital stay (3 days vs. 1.4 days, p < 0.001), greater estimated blood loss (237 cm3 vs. 102 cm3, p < 0.001), larger uterine weight (136 g vs. 116 g, p < 0.001), as well as higher incidence of postoperative complications [29.3% vs. 6.7%, odds ratio (OR) 5.82, 95% confidence interval (CI) 2.1-11.7] including postoperative ileus (9.0% vs. 1.0%, OR 7.82, 95% CI 1.7-35.0), wound infection (6.0% vs. 1.0%, OR 5.43, 95% CI 1.2-25.2), and postoperative atelectasis (4.0% vs. 0%, p < 0.01). There were no differences in projected 5-year progression-free and overall survival rates. Conclusion: Use of the daVinci robotic system was associated with less intraoperative blood loss, fewer postoperative complications, and shorter hospital stay compared with laparotomy for patients with uterine weight less than 480 g.

AB - Study Objective: To directly compare perioperative morbidity and hospital stay after robotic-assisted staging and laparotomy in patients with early stage endometrial endometrioid adenocarcinoma and uterine weight under 480 g. Design: Retrospective cohort study. Setting: The West Clinic in Memphis, TN, USA. Patients: Patients with Stage IA and Stage IB endometrial endometrioid adenocarcinoma and uterine weight less than 480 g from June 2007 to January 2011. Interventions: Patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection with or without para-aortic lymph node dissection using robotic-assisted surgery or open laparotomy. Measurements: Perioperative complications and morbidity, length of hospital stay, progression-free survival, overall survival, time to recurrence, and time do death from disease. Main Results: A total of 160 patients who underwent laparotomy and 165 patients who received robotic-assisted staging were identified. Compared with robotic-assisted staging, laparotomy was associated with increased hospital stay (3 days vs. 1.4 days, p < 0.001), greater estimated blood loss (237 cm3 vs. 102 cm3, p < 0.001), larger uterine weight (136 g vs. 116 g, p < 0.001), as well as higher incidence of postoperative complications [29.3% vs. 6.7%, odds ratio (OR) 5.82, 95% confidence interval (CI) 2.1-11.7] including postoperative ileus (9.0% vs. 1.0%, OR 7.82, 95% CI 1.7-35.0), wound infection (6.0% vs. 1.0%, OR 5.43, 95% CI 1.2-25.2), and postoperative atelectasis (4.0% vs. 0%, p < 0.01). There were no differences in projected 5-year progression-free and overall survival rates. Conclusion: Use of the daVinci robotic system was associated with less intraoperative blood loss, fewer postoperative complications, and shorter hospital stay compared with laparotomy for patients with uterine weight less than 480 g.

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