Robotic Total Mesometrial Resection versus Laparoscopic Total Mesometrial Resection in Early Cervical Cancer: A Case-Control Study

Abstract

Study Objective: To report our experience with robotic total mesometrial resection (R-TMMR) comparing perioperative results with a series of laparoscopic total mesometrial resections (L-TMMRs). Design: Multicenter retrospective case-control study (Canadian Task Force classification II-2). Setting: Catholic University of the Sacred Heart of Rome (Italy) and Campobasso (Italy). Patients: From July 2013 to August 2015 all cervical cancer patients with preoperative FIGO stage IA2 to IB1 were assessed at preoperative magnetic resonance imaging scan and clinically confirmed by investigation under anesthesia, complying strictly with the FIGO criteria. Surgical and postsurgical data of the TMMR procedures were collected. Interventions: R-TMMR and L-TMMR for early cervical cancer were performed. Measurements and Main Results: Twenty-one women underwent R-TMMR (cases) and 42 patients were submitted to L-TMMR (control subjects) for early cervical cancer. The median estimated blood loss was 150 mL in the cases and 200 mL in the control subjects (p = .992). The median operative time, calculated from the beginning of intraperitoneal procedures to skin closure, was 246 minutes in the cases and 260 minutes in the control subjects (p = .913). The median time to discharge from the hospital was postoperative days 4 (range, 2-5) and 6 (range, 4-15) for R-TMMR and L-TMMR, respectively (p = .001). Conclusion: The few differences we registered do not seem to be clinically relevant, thus making the 2 procedures comparable. Further prospective trials are needed to confirm our results.