Comparing Hysterectomies for Endometrial Cancer

Each year, more than 40,000 women are diagnosed with endometrial cancer in the United States. This diagnosis, often resulting in the need for a hysterectomy, leads many patients to consider their treatment options. Tradi­tionally, the surgical options have been somewhat limited for these women, including open hysterectomy and laparos­copy. Open hysterectomy has been associated with important caveats for patients to consider, including scarring, excessive procedural blood loss, and extended hospital stays with long recovery times. Minimally invasive laparoscopy significantly reduces some of the risks associated with open hysterectomy. Robotic surgery equipment has also emerged after receiving FDA clearance in 2005, and these procedures are increas­ingly being used for patients with endometrial cancer. Treatment Options for Endometrial Cancer In the December 2010 issue of Obstetrics & Gynecology, my colleagues and I reviewed eight studies involving nearly 1,600 women who underwent open surgery, laparoscopy, robot-assisted hysterectomy, or lymph node dissection. We compared them with laparoscopic or laparotomy cases to analyze surgical technique, complications, and periopera­tive outcomes. Comparative studies that looked at clinical outcomes of robotic-assisted surgeries were also summarized and compared with traditional laparoscopic or laparotomy techniques for the treatment of endometrial cancer. “Robotic-assisted surgery has the potential for enhancing outcomes in women receiving operative treatment for endometrial cancer.” According to our analysis, women undergoing surgery for endometrial cancer can benefit from minimally invasive hysterectomy that is performed by skilled surgeons with or without the help of robotic technology. Laparoscopic surgery with or without robotic assistance took about the same time to complete and resulted in similar hospital stay durations. It should be noted, however, that about half as much blood was...