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Robotics Versus Laparoscopic Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: A Multicenter Study

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to retrospectively compare the safety, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (TLRH) with lymphadenectomy and total robotic radical hysterectomy (RRH) with lymphadenectomy for early cervical carcinoma in a series of 99 consecutive women.

Materials and Methods

We studied 99 consecutive patients with FIGO stage Ia1 (LVSI), Ia2, Ib1, Ib2, and IIa cervical cancer, 76 of whom underwent TLRH and 23 underwent RRH with pelvic lymph node dissection. Para-aortic lymphadenectomy, with the superior border of the dissection being the inferior mesenteric artery, was performed in all cases with positive pelvic lymph nodes discovered at frozen section evaluation.

Results

The mean blood loss was 157 ml in the RRH group (95% confidence interval [95% CI] 50–400) and 95 ml in the TLRH group (95% CI 30–500) (not significant [NS]). The median length of hospital stay was 3 days in the RRH group (95% CI 2–7) and 4 days in the TLRH group (95% CI 3–7) (NS). The mean operating time was 255 min for the TLRH group (95% CI 182–415) compared with 323 min in the RRH group (95% CI 161–433) (P < 0.05). No significant difference was found between the 2 groups when comparing the recurrence rate.

Conclusions

Robotic radical hysterectomy can be considered a safe and effective therapeutic procedure for managing early-stage cervical cancer without significant differences, if compared with laparoscopic radical hysterectomy, in terms of the recurrence rate and intraoperative and postoperative complications, although multicenter randomized clinical trials with longer follow-up are necessary to evaluate the overall oncologic outcomes of this procedure.

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Authors and Affiliations

  1. Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy

    Raffaele Tinelli MD, Mario Malzoni MD, Francesco Cosentino MD & Ciro Perone MD

  2. Department of Public Health, University Medical School of Bari, Bari, Italy

    Annarita Fusco MD

  3. 4th Department of Obstetrics and Gynecology, University Medical School of Bari, Bari, Italy

    Ettore Cicinelli MD

  4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Mount Sinai Medical Center, New York, NY, USA

    Farr Nezhat MD

Authors
  1. Raffaele Tinelli MD
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  2. Mario Malzoni MD
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  3. Francesco Cosentino MD
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  4. Ciro Perone MD
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  5. Annarita Fusco MD
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  6. Ettore Cicinelli MD
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  7. Farr Nezhat MD
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Correspondence to Raffaele Tinelli MD.

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Tinelli, R., Malzoni, M., Cosentino, F. et al. Robotics Versus Laparoscopic Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: A Multicenter Study. Ann Surg Oncol 18, 2622–2628 (2011). https://doi.org/10.1245/s10434-011-1611-9

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  • DOI: https://doi.org/10.1245/s10434-011-1611-9

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