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Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer.

Abstract Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title danish medical journal
Publication Year Start




PMID- 28260596
OWN - NLM
STAT- MEDLINE
DA  - 20170306
DCOM- 20170313
LR  - 20170313
IS  - 2245-1919 (Electronic)
IS  - 2245-1919 (Linking)
VI  - 64
IP  - 3
DP  - 2017 Mar
TI  - Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer.
LID - A5343 [pii]
AB  - INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a
      widely used approach for women with endometrial cancer and has replaced
      laparotomy. It has been questioned if the increased costs are justified by
      superior surgical outcomes. The aim of the present study was to examine the
      frequency, types and severity of post-operative complications after total
      abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of
      surgical outcomes. METHODS: A non-randomised, controlled before and after study
      of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls).
      RESULTS: RALH had significant advantages compared with TAH: fewer and less severe
      post-operative complications and a shorter length of hospital stay. The absolute 
      risk reduction for post-operative complications was 13% (95% confidence interval:
      4.29-20.87%). Women treated with TAH had significantly more severe complications 
      (grade >/= 3) than those treated with RALH; 12% versus 3% (p = 0.001). Infections
      (urinary and port site) were the most frequent post-operative complications
      overall. The duration of RALH in the operation theatre was longer, while the
      duration of stay in the post-anaesthesia care unit was shorter for patients
      undergoing RALH. CONCLUSIONS: RALH appears advantageous for women treated for
      endometrial cancer in terms of post-operative complications. We recommend the use
      of the Clavien-Dindo classification of surgical outcomes for quality assessment. 
      FUNDING: departmental only. TRIAL REGISTRATION: Danish Health Authority
      (3-2013-111/1/KAHO).
FAU - Herling, Suzanne Forsyth
AU  - Herling SF
AD  - suzanne.herling@gmail.com.
FAU - Moller, Ann M
AU  - Moller AM
FAU - Palle, Connie
AU  - Palle C
FAU - Grynnerup, Anja
AU  - Grynnerup A
FAU - Thomsen, Thordis
AU  - Thomsen T
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Dan Med J
JT  - Danish medical journal
JID - 101576205
SB  - IM
MH  - Aged
MH  - Controlled Before-After Studies
MH  - Denmark
MH  - Endometrial Neoplasms/*surgery
MH  - Female
MH  - Humans
MH  - Hysterectomy/*adverse effects/methods
MH  - Laparoscopy/*methods
MH  - Length of Stay
MH  - Middle Aged
MH  - Postoperative Complications/diagnosis/*prevention & control
MH  - Robotic Surgical Procedures/*adverse effects
EDAT- 2017/03/07 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/07 06:00
AID - A5343 [pii]
PST - ppublish
SO  - Dan Med J. 2017 Mar;64(3). pii: A5343.

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