Robot-assisted surgery in cervical cancer patients reduces the time to normal activities of daily living

Katrin C. Asciutto1, Grigorios Kalapotharakos1, Mats Löfgren2, Thomas Högberg3 andChrister Borgfeldt1,

Objective

To evaluate current surgical cervical cancer treatment in Sweden 2008–12.

Design and setting

Analysis of data in the Swedish National Quality Register for Gynecological Surgery (GynOP).

Sample

A total of 249 cervical cancer patients undergoing surgery.

Methods

Analysis of prospectively gathered preoperative and postoperative data including patient-reported information.

Main outcome measures

Mean operating time, blood loss/transfusion, length of hospital stay, return to activities of daily living.

Results

The patients undergoing laparoscopic robot-assisted surgery (n = 64) or laparotomy (n = 185) did not differ in age, body mass index, American Society of Anesthesiologists score, International Federation of Gynecology and Obstetrics (FIGO) stage or mean operating time. Blood loss was higher in the laparotomy group (p < 0.001). Thirteen patients in the laparotomy group (7%) received a blood transfusion, but none in the robot group. Intraoperative complications were more common in the laparotomy group (p = 0.03). Re-admission or operations did not differ between the groups. The number of pelvic lymph nodes removed was significantly higher in the laparotomy group (median 31 vs. 24, p < 0.001). There was no difference regarding the number of patients with lymph node metastases in the two groups. The postoperative length of hospital stay was longer in the laparotomy group compared with the robot group (6.1 days vs. 2.1 days, p = 0.01). The patient-reported time to resume normal activities of daily living was longer in the laparotomy than the robot group (13.4 days vs. 9.7 days, p = 0.04).

Conclusions

Laparoscopic robotic-assisted surgery is preferable to laparotomy for cervical cancer patients because it entails a significantly shorter hospital stay, less blood loss, fewer intraoperative complications and shorter time to normal daily activities.

Acta Obstetricia et Gynecologica Scandinavica

Volume 94, Issue 3, March 2015

DOI: 10.1111/aogs.12561