Does the use of a uterine manipulator in robotic surgery for early-stage endometrial cancer affect oncological outcomes?
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Hiroe Ito1, Tetsuya Moritake1,2, Keiichi Isaka1,3
1Department of Obstetrics and Gynecology, Tokyo Medical University Hospital, Shinjuku-ku, Japan.
Background:
To investigate the impact of the use of a uterine manipulator in robot-assisted surgery for early-stage endometrial cancer on oncological outcome.
Methods:
Eighty six robotic surgeries and sixty seven open surgeries were performed for early-stage endometrial cancer. Disease-free survival and overall survival at 5 years, and surgical results and postoperative complications were compared between surgeries. In robotic surgery, a uterine manipulator was used in all cases.
Results:
There was no significant difference in oncological outcome between surgeries. Robotic surgery showed significantly longer operative time, less blood loss, and shorter hospital stay compared to open surgery. In robotic surgery, complications occurred significantly less frequently, and no patients required conversion to laparotomy. There were no clear correlations of positive lavage cytology with The International Federation of Gynecology nd Obstetrics stage, recurrence, and site of recurrence in either surgery.
Conclusions:
The use of a uterine manipulator during robotic surgery for early-stage endometrial cancer did not influence recurrence or survival.
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