Comparison of Perioperative and Oncologic Outcomes with Laparotomy, and Laparoscopic or Robotic Surgery for Women with Endometrial Cancer

Purpose: To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treatedwith laparotomy, and laparoscopic or robotic surgery. Materials and
Methods: Endometrial cancer patients whounderwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperativeoutcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intraand postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival(OS) were compared.
Results: Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, p<0.05) while the robotic grouphad the longest operative time (302 min) as compared with laparoscopy (180 min) and laparotomy (125 min)(p<0.05). Intra and postoperative complications were not different with any of the surgical approaches. Nosignificant difference in number of lymph nodes retrieved was identified. The longest hospital stay was reportedin the laparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic(three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p=0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among thethree groups.
Conclusions: Minimally invasive surgery has more favorable outcomes, including lower blood loss,shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complicationsand short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer