Abstract
Study Objective Although laparoscopic radical hysterectomy (LRH) and robotic radical hysterectomy (RRH) are both minimally invasive procedures commonly performed for the treatment of early-stage cervical cancer, there is little high quality data on the head-to-head comparison of these two procedures. We sought to perform the largest study to date to compare the efficacy and complications of these two procedures. Design Systematic Review and Meta-Analysis. Setting Gynecologic Oncology. Patients or Participants Women suffering from early-stage cervical cancer. We included retrospective cohorts, prospective cohorts, case-control, and randomized clinical trials. Interventions Laparoscopic radical hysterectomy compared with Robotic radical hysterectomy. Measurements and Main Results We found that following RRH, women had a decreased hospital stay (MD=0.80[0.38,1.21], (P<0.002). We found no differences in estimated blood loss (MD=35.24[-0.40,70.89],(P=.05), blood transfusion rate ((OR=1.32[0.86,2.02],(P=0.20), rate of post-operative complications (OR=0.84[0.60,1.17],(P=0.30), the operative time (MD=6.01[-4.64,16.66],(P=0.27), number of resected lymph node (MD=-1.22[-3.28,0.84],(P=0.25) intraoperative complications (OR=0.78[0.51,1.19],(P=0.25), five-year overall survival (OR=1.37[0.51,3.69],(P=0.53), lifetime disease free survival (OR=0.89[0.59,1.32],(P=0.55), intraoperative and postoperative mortality (within 30 days) (OR=1.30[0.66,2.54],(P=0.44), and recurrence (OR=1.14[0.79,1.64],(P = 0.50). Conclusion RRH seems to result in the patient leaving the hospital sooner after surgery. We were unable to find any differences in our ten other outcomes related to complications or efficacy. Although laparoscopic radical hysterectomy (LRH) and robotic radical hysterectomy (RRH) are both minimally invasive procedures commonly performed for the treatment of early-stage cervical cancer, there is little high quality data on the head-to-head comparison of these two procedures. We sought to perform the largest study to date to compare the efficacy and complications of these two procedures. Systematic Review and Meta-Analysis. Gynecologic Oncology. Women suffering from early-stage cervical cancer. We included retrospective cohorts, prospective cohorts, case-control, and randomized clinical trials. Laparoscopic radical hysterectomy compared with Robotic radical hysterectomy. We found that following RRH, women had a decreased hospital stay (MD=0.80[0.38,1.21], (P<0.002). We found no differences in estimated blood loss (MD=35.24[-0.40,70.89],(P=.05), blood transfusion rate ((OR=1.32[0.86,2.02],(P=0.20), rate of post-operative complications (OR=0.84[0.60,1.17],(P=0.30), the operative time (MD=6.01[-4.64,16.66],(P=0.27), number of resected lymph node (MD=-1.22[-3.28,0.84],(P=0.25) intraoperative complications (OR=0.78[0.51,1.19],(P=0.25), five-year overall survival (OR=1.37[0.51,3.69],(P=0.53), lifetime disease free survival (OR=0.89[0.59,1.32],(P=0.55), intraoperative and postoperative mortality (within 30 days) (OR=1.30[0.66,2.54],(P=0.44), and recurrence (OR=1.14[0.79,1.64],(P = 0.50). RRH seems to result in the patient leaving the hospital sooner after surgery. We were unable to find any differences in our ten other outcomes related to complications or efficacy.
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