Outcomes of Robotic vs. Total Abdominal Hysterectomy Stratified by Age Group for Patients with Endometrial Cancer [19A]. (May 2018) - Javadian, Pouya
Abstract : INTRODUCTION: To compare clinical and pathologic features, surgical morbidity, and outcomes stratified by age in patients with endometrial cancer who underwent Robotic-assisted laparoscopic total hysterectomy (RALTH) vs. Total Abdominal Hysterectomy METHODS: All women with surgically treated endometrial cancer at the Newark Beth Israel Medical Center between January 2004 and December 2015 were eligible; 353 patients met criteria and underwent retrospective chart review. Patients were stratified into 3 groups based on age the ranges <45, 46-64 and >65 years. Demographic data, pathologic, surgical treatment and complications were retrospectively reviewed. Statistical analysis was performed by SPSS. RESULTS: There were no statistically significant differences regarding operation characteristics and complications in patients with age <45 years. In patients of age between 46-64 years, there was a statistically significant increased estimated blood loss (EBL), median (range), (400 (50-6000) cc vs. 100 (20-7000) cc, p : <0.001) and length of stay (LOS) 4 (1-51) vs. 1.5 (1-41) days, p : <0.001 in the TAH group compared to the RALTH group. Patients who underwent RALTH experienced longer operative time than the TAH group (234.3±81.2 vs. 259.5±68.4, p:0.039). In patients with age >65 years, LOS [7 (2-39) vs. 2 (1-43) days, p<0.001] and intra-operative hemorrhage [14/79 (17.7%) vs. 1/78 (1.2%), p<0.001] were significantly higher in TAH than the RALTH patients. CONCLUSION: Older patients with endometrial cancer benefit from the lower rate of postoperative complications with RALTH than TAH. Patients undergoing RALTH benefit from decreased postoperative morbidity.