Comparison of Robotic-assisted and Conventional Total Laparoscopic Hysterectomy for Atypical Complex Hyperplasia and Early-stage Endometrial Carcinoma in the Hong Kong Chinese Population

Abstract

Objectives: To compare the outcomes of conventional total laparoscopic hysterectomy with robotic-assisted total laparoscopic hysterectomy in Chinese patients with early-stage endometrial carcinoma and atypical complex hyperplasia.
Methods: This retrospective study was performed at the Pamela Youde Nethersole Eastern Hospital from 1 January 2010 to 30 July 2012. The study compared conventional and robotic-assisted total laparoscopic hysterectomies for International Federation of Gynecology and Obstetrics stage 1A grade 1-2 endometrial carcinoma or atypical complex hyperplasia in a Chinese population.
Results: A total of 19 women underwent conventional total laparoscopic hysterectomy and 26 women underwent robotic-assisted total laparoscopic hysterectomy. The robotic-assisted group had significantly less postoperative opiate use (0% vs. 26.3%; p=0.01) and fewer postoperative complications (3.8% vs. 52.6%; p<0.001) than the conventional group. All robotic-assisted total laparoscopic hysterectomies were performed by consultants, but for conventional total laparoscopic hysterectomies, the proportion was only 11 (57.9%) cases (p<0.001).
Conclusion: Robotic-assisted total laparoscopic hysterectomy is as safe and efficient as conventional total
laparoscopic hysterectomy for treating atypical complex hyperplasia and early-stage endometrial carcinoma in a Chinese population. Whether fewer short-term complications and less opiate use were due to the use of roboticassisted surgery or surgeons’ experience could not be determined in this study.