A Comparison between Robotic-Assisted Laparoscopic Hysterectomy and Laparotomy for the Treatment of Endometrial Cancer

Abstract

Endometrial cancer is the most common gynecologic cancer in US. In 2010, there were 43,470 new cases and 7950 deaths. The aim of the study is to compare robotic-assisted laparoscopic hysterectomy (RALH) to laparotomy (TAH) for endometrial cancer treatment in term of operative details, intra and post operative complications and cost analyses. Retrospective chart review. University teaching hospital. Charts involving patients diagnosed with endometrial cancer at Karmanos Cancer Institute from 2006-2011, a total of 398 patients. Patient's demographics, operative details, intra-op complications and post operative complication in the first 30 days were gathered. Chi square, t-test & Mann-Whitney test used for statistical analysis. T-test used for intra-op and post op cost analyses. 398 patients underwent surgical staging for endometrial cancer including 291 TAH and 107 RALH. Estimated blood loss and length of hospital stay were statistically higher in TAH (p = 0.000 and 0.046 respectively). Median number of LN (lymph nodes) was statistically higher in RALH (p = 0.022). There was no statistical difference in the intra-op and post-op complications between both groups. RALH has a statistically higher OR (operative room) direct, OR time and anesthesia time expenses (p = 0.000 for all). TAH has a statistically higher inpatient, total direct expenses and gross charges (p = 0.004, 0.000 and 0.003 respectively). RALH for endometrial cancer has significantly less blood loss, higher number of LN dissected and shorter hospital stay compared to TAH. There is no statistically significant difference in surgical time, intra op or post op complications. Overall, RALH is a more cost effective procedure for treatment of endometrial cancer.