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Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan.
- Source :
-
Surgical endoscopy [Surg Endosc] 2024 Aug; Vol. 38 (8), pp. 4390-4401. Date of Electronic Publication: 2024 Jun 17. - Publication Year :
- 2024
-
Abstract
- Background: Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors.<br />Methods: Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias.<br />Results: In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml, p < 0.001), lower transfusion rate (RPE vs. OPE: 32% vs. 82%, p < 0.001), and lower rate of complications over Clavien-Dindo grade II (RPE vs. OPE: 48% vs. 74%, p = 0.013; RPE vs. LPE: 48% vs. 76%, p = 0.002).<br />Conclusion: This multicenter study suggests that RPE reduces blood loss and transfusion compared with OPE and has a lower rate of complications compared with OPE and LPE in patients with locally advanced and recurrent pelvic tumors.<br /> (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Humans
Female
Retrospective Studies
Male
Middle Aged
Japan
Aged
Postoperative Complications epidemiology
Postoperative Complications etiology
Treatment Outcome
Adult
Blood Loss, Surgical statistics & numerical data
Blood Transfusion statistics & numerical data
Length of Stay statistics & numerical data
Operative Time
Propensity Score
Laparoscopy methods
Robotic Surgical Procedures methods
Pelvic Neoplasms surgery
Pelvic Exenteration methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 38
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 38886231
- Full Text :
- https://doi.org/10.1007/s00464-024-10966-w