Cargando…

Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience

OBJECTIVES: Minimally invasive surgery (MIS) has become the preferred option for many gynecologic pathologies since complication rate and postoperative recovery time have decreased considerably. Postoperative complications remain an important aspect when using the MIS approach, if they are not timel...

Descripción completa

Detalles Bibliográficos
Autores principales: Minciuna, Corina-Elena, Ivanov, Mihail, Aioanei, Sanziana, Tudor, Stefan, Lacatus, Monica, Vasilescu, Catalin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683964/
https://www.ncbi.nlm.nih.gov/pubmed/38034104
http://dx.doi.org/10.4103/gmit.gmit_137_22
_version_ 1785151297581744128
author Minciuna, Corina-Elena
Ivanov, Mihail
Aioanei, Sanziana
Tudor, Stefan
Lacatus, Monica
Vasilescu, Catalin
author_facet Minciuna, Corina-Elena
Ivanov, Mihail
Aioanei, Sanziana
Tudor, Stefan
Lacatus, Monica
Vasilescu, Catalin
author_sort Minciuna, Corina-Elena
collection PubMed
description OBJECTIVES: Minimally invasive surgery (MIS) has become the preferred option for many gynecologic pathologies since complication rate and postoperative recovery time have decreased considerably. Postoperative complications remain an important aspect when using the MIS approach, if they are not timely or accurately diagnosed and treated. The main aim of the study is to first assess their incidence, followed by identifying possible risk factors. Furthermore, the secondary aim is to identify if the type of MIS approach used, robotic or laparoscopic, may render some additional benefits. MATERIALS AND METHODS: The database of the General Surgery Department was queried between 2008 and 2019 for patients with gynecologic pathology: 2907 cases were identified. An additional selection was performed using the following filters: MIS and neoplasia. All emergency surgeries were excluded. One hundred and ninety-eight cases were obtained. RESULTS: The majority of complications were urological (11.6%) with only 7.07% requiring a specific urological procedure. The second most common was lymphorrhea 4.5%. Dindo–Clavien classification correlates positively with the postoperative hospital stay (PHS) (P = 0.000), the type of surgery (P = 0.046), the primary tumor location (P = 0.011), conversion rate (P = 0.049), the expertise of the lead surgeon (P = 0.012), and the operative time (P = 0.002). The urological complications correlate positively with the type of surgery (P = 0.002), the tumor location (P = 0.001), early reintervention (P = 0.000), operative time (P = 0.006), postoperative hemorrhage (P = 0.000), pelvic abscess (P = 0.000), venous thrombosis (P = 0.011), and postoperative cardiac complications (P = 0.002). Laparoscopic and robotic approaches were comparatively assessed. The PHS (P = 0.025), the type of surgery performed (P = 0.000), and primary tumor location (P = 0.011) were statistically significantly different. CONCLUSION: Postoperative complications reported after MIS for gynecological malignancies show similar incidence as in the current literature, also taking into consideration those for the open approach. The robotic approach seems to be able to perform more complex surgeries with no difference in the postoperative complication rates. The expertise of the lead surgeon in gynecology correlates with lower postoperative complications. Further prospective studies are needed to confirm these results.
format Online
Article
Text
id pubmed-10683964
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-106839642023-11-30 Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience Minciuna, Corina-Elena Ivanov, Mihail Aioanei, Sanziana Tudor, Stefan Lacatus, Monica Vasilescu, Catalin Gynecol Minim Invasive Ther Original Article OBJECTIVES: Minimally invasive surgery (MIS) has become the preferred option for many gynecologic pathologies since complication rate and postoperative recovery time have decreased considerably. Postoperative complications remain an important aspect when using the MIS approach, if they are not timely or accurately diagnosed and treated. The main aim of the study is to first assess their incidence, followed by identifying possible risk factors. Furthermore, the secondary aim is to identify if the type of MIS approach used, robotic or laparoscopic, may render some additional benefits. MATERIALS AND METHODS: The database of the General Surgery Department was queried between 2008 and 2019 for patients with gynecologic pathology: 2907 cases were identified. An additional selection was performed using the following filters: MIS and neoplasia. All emergency surgeries were excluded. One hundred and ninety-eight cases were obtained. RESULTS: The majority of complications were urological (11.6%) with only 7.07% requiring a specific urological procedure. The second most common was lymphorrhea 4.5%. Dindo–Clavien classification correlates positively with the postoperative hospital stay (PHS) (P = 0.000), the type of surgery (P = 0.046), the primary tumor location (P = 0.011), conversion rate (P = 0.049), the expertise of the lead surgeon (P = 0.012), and the operative time (P = 0.002). The urological complications correlate positively with the type of surgery (P = 0.002), the tumor location (P = 0.001), early reintervention (P = 0.000), operative time (P = 0.006), postoperative hemorrhage (P = 0.000), pelvic abscess (P = 0.000), venous thrombosis (P = 0.011), and postoperative cardiac complications (P = 0.002). Laparoscopic and robotic approaches were comparatively assessed. The PHS (P = 0.025), the type of surgery performed (P = 0.000), and primary tumor location (P = 0.011) were statistically significantly different. CONCLUSION: Postoperative complications reported after MIS for gynecological malignancies show similar incidence as in the current literature, also taking into consideration those for the open approach. The robotic approach seems to be able to perform more complex surgeries with no difference in the postoperative complication rates. The expertise of the lead surgeon in gynecology correlates with lower postoperative complications. Further prospective studies are needed to confirm these results. Wolters Kluwer - Medknow 2023-09-07 /pmc/articles/PMC10683964/ /pubmed/38034104 http://dx.doi.org/10.4103/gmit.gmit_137_22 Text en Copyright: © 2023 Gynecology and Minimally Invasive Therapy https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Minciuna, Corina-Elena
Ivanov, Mihail
Aioanei, Sanziana
Tudor, Stefan
Lacatus, Monica
Vasilescu, Catalin
Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title_full Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title_fullStr Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title_full_unstemmed Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title_short Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience
title_sort short-term outcome of robotic and laparoscopic surgery for gynecological malignancies: a single-center experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683964/
https://www.ncbi.nlm.nih.gov/pubmed/38034104
http://dx.doi.org/10.4103/gmit.gmit_137_22
work_keys_str_mv AT minciunacorinaelena shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience
AT ivanovmihail shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience
AT aioaneisanziana shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience
AT tudorstefan shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience
AT lacatusmonica shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience
AT vasilescucatalin shorttermoutcomeofroboticandlaparoscopicsurgeryforgynecologicalmalignanciesasinglecenterexperience