Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3185-3193
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3185
Comparative analysis of robotic vs laparoscopic radical hysterectomy for cervical cancer
Li Chen, Li-Ping Liu, Na Wen, Xiao Qiao, Yuan-Guang Meng
Li Chen, Na Wen, Yuan-Guang Meng, Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing 100853, China
Li-Ping Liu, Department of Obstetrics and Gynecology, The First Central Hospital of Baoding, Baoding 071000, Hebei Province, China
Xiao Qiao, Medical Big Data Center, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Chen L and Liu LP contributed equally to this work and should be considered as co-first authors; Chen L and Meng YG performed the research and wrote the paper; Wen N and Qiao X contributed data collection and analytic tools.
Institutional review board statement: All specimens from the patients were obtained after their informed consent and ethical permission was obtained for participation in the study.
Informed consent statement: The patient’s legal guardian provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yuan-Guang Meng, MD, PhD, Professor, Department of Obstetrics and Gynecology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. mengyg6512@163.com
Telephone: +86-10-66938443 Fax: +86-10-66938443
Received: June 11, 2019
Peer-review started: June 18, 2019
First decision: July 30, 2019
Revised: August 24, 2019
Accepted: September 9, 2019
Article in press: September 9, 2019
Published online: October 26, 2019
Abstract
BACKGROUND

Cervical cancer is the most common gynecological malignancy, ranking first in female reproductive malignancies with more than 500000 new cases and 275000 deaths each year. Traditionally, open radical hysterectomy is considered the standard surgical procedure for the treatment of resectable cervical cancer. The latest guidelines from the National Comprehensive Cancer Network and the European Society of Gynecological Oncology suggest that open surgery and laparoscopic surgery (using traditional laparoscopic or robotic techniques) are the main surgical approaches for radical hysterectomy for patients with stage IA2-IIA cervical cancer. Robotic surgery has been increasingly used in abdominal surgery and has shown more beneficial effects.

AIM

To analyse the perioperative conditions, complications, and short-term and long-term effects in patients undergoing robotic radical hysterectomy (RRH) and laparoscopic radical hysterectomy (LRH) to compare their clinical efficacy, safety, and feasibility.

METHODS

The perioperative data of patients undergoing RRH and LRH were extracted and collected from the database of surgical treatments for cervical cancer for statistical analysis.

RESULTS

Of the patients, 342 underwent LRH for cervical cancer, and 216 underwent RRH. The total complication rate was 9.65% (20 patients) in the RRH group and 17.59% (60 patients) in the LRH group. The complication rate was significantly lower in the RRH group than in the LRH group. There was no significant difference in the follow-up period (P = 0.658). The total recurrence rates were 15.7% and 12% in the RRH and LRH groups, respectively. The progression-free survival time was 28.91 ± 15.68 mo and 28.34 ± 15.13 mo in the RRH and LRH groups, respectively (P = 0.669). The overall survival (OS) rates were 92.13% and 94.45% in the RRH and LRH groups, respectively (P = 0.292). The OS time was 29.87 ± 15.92 mo and 29.41 ± 15.14 mo in the RRH and LRH groups, respectively (P = 0.732). The survival curves and the progression-free survival curves were not statistically significantly different between the two groups (P = 0.407 and 0.28, respectively).

CONCLUSION

RRH is associated with significantly less operative time and blood loss than LRH. The two procedures have similar complication rates, OS, and progression-free survival time.

Keywords: Cervical cancer, Robotic radical hysterectomy, Laparoscopy, Survival

Core tip: The perioperative data of patients undergoing robotic radical hysterectomy (RRH) and laparoscopic radical hysterectomy (LRH) were extracted and collected from the database of surgical treatments for cervical cancer for statistical analysis. Of the patients, 342 underwent LRH for cervical cancer, and 216 underwent RRH. The operative time and blood loss were significantly less in the RRH group than in the LRH group. The two groups had similar complication rates, overall survival, and progression-free survival time.