BACKGROUND AND PURPOSE: 

• Benefits associated with minimally invasive surgery (benign and malignant) include 
  • Less blood loss and need for transfusion 
  • Decreased postoperative pain 
  • Shorter hospital stay 
  • Better quality of life 
• Casarin et al. (Obstetrics & Gynecology, 2018) examined how the widespread adoption of minimally invasive surgery in the US has affected 30-day morbidity and mortality related to endometrial cancer treatment 

METHODS: 

• Retrospective cohort study 
• Patients undergoing hysterectomy for early-stage endometrial cancer were collected from the American College of Surgeons’ National Surgical Quality Improvement Project  
• The following endometrial cancer treatment approaches were analyzed  
  • Laparotomy 
  • Vaginal surgery 
  • Minimally invasive surgery 
• 30-day outcomes were compared between patients who had minimally invasive surgery and open surgery 

RESULTS: 

• Data was collected from 12,283 patients  
• There was a significant implementation of minimally invasive surgery (24.2-71.4%) and decrease in open surgery through laparotomy (71.1-26.4%) between 2008 and 2014 (bothP<.001) 
• Rate of vaginal surgery remained constant over time (1.5–2.2%,P=.06) 
• After adjusting for possible confounders, open surgery compared to minimally invasive surgery was independently associated with 
  • Increased odds of major complications  
    • Adjusted odds ratio (OR) 2.4; 95% CI 2.0–2.8 
  • Readmission  
    • Adjusted OR 2.2;95% CI 1.8–2.6 
  • Reoperation  
    • Adjusted OR 1.5; 95% CI 1.2–2.1 
  • Superficial surgical site infection  
    • Adjusted OR 6.8; 95% CI 5.0–9.2 
  • Perioperative transfusion  
    • Adjusted OR 5.9; 95% CI 4.8–7.1 
  • Death  
    • Adjusted OR 3.8; 95% CI 2.2–6.6 

CONCLUSION: 

• The use of minimally invasive surgery in the treatment for endometrial cancer has been associated with decreased 30-day morbidity and mortality  
• The increased use of minimally invasive surgery can be attributed to increased knowledge and also availability of robotics 

Learn More – Primary Sources: 

Adoption of Minimally Invasive Surgery and Decrease in Surgical Morbidity for Endometrial Cancer Treatment in the United States

Related ObG Topics:

Ovarian or Endometrial Cancer? Consider Lynch Syndrome

Endometrial Cancer: The Basics

TLH vs. TAH for Endometrial Cancer – Results from the LACE trial  

ProMisE Study: Genetic Basis for Classifying Endometrial Cancer

Is Progesterone Therapy an Effective Treatment for Endometrial Cancer?