子宮体癌IA期に対するロボット支援下手術の手術成績に関する後方視的検討

Abstract

Objective: This study aimed to analyze the surgical outcomes of robotic-assisted surgery for early-stage endometrial cancer compared with those of laparoscopic surgery and laparotomy. Methods: The clinical data and perioperative outcomes of stage IA endometrial cancer patients who underwent total hysterectomy, bilateral salpingo-oophrectomy, and pelvic lymphadenectomy by robotic-assisted surgery, laparoscopic surgery or laparotomy from January 2011 through December 2020 were reviewed and analyzed retrospectively. Results: A total of 122 patients were eligible (robotic-assisted surgery, n=24; laparoscopic surgery, n=72; laparotomy, n=26). The median operation time for robotic-assisted surgery was longer than that for laparoscopic surgery and laparotomy (P < 0.0001). Robotic-assisted surgery resulted in less blood loss (P < 0.0001) and a shorter postoperative stay (P < 0.001) than laparotomy but was not different from laparoscopic surgery. There was no difference in the number of lymph nodes retrieved among the three groups. Three (17%) robotic-assisted surgeries, 6 (8%) laparoscopic surgeries, and 3 (12%) laparotomies resulted in perioperative complications (P=0.47). Two patients who underwent laparoscopic surgery developed recurrence. Conclusions: Robotic-assisted surgery has similar surgical outcomes to laparoscopic surgery and offers a safe alternative in the surgical treatment of early-stage endometrial cancer, although the operative time may need to be shortened.