The Role of Robotic Surgery Versus Laparotomy on the Incidence of Thromboembolism in Uterine Cancer [21P]

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Abstract

INTRODUCTION:

Thromboembolism represents a major cause of morbidity and mortality following gynecologic surgery. The purpose of this study is to explore the influence of robotic surgery as a risk reduction factor in thromboembolism in patients who were treated surgically for uterine cancer.

METHODS:

A retrospective analysis of patients who underwent surgery for uterine cancer between 2005 and 2014 at Newark Beth Israel Medical Center. Data on demographics, diagnosis, comorbidities, perioperative characteristics, thromboprophylaxis and thromboembolism diagnosis were reviewed. The results were analyzed using the Fisher exact test and independent-sample t test.

RESULTS:

A total of 182 patients were identified, 95 underwent laparotomy and 87 underwent robotic surgery. All patients had thromboprophylaxis using mechanical devices during and after surgery. Hundred patients received thromboprophylaxis with pharmacological agents postoperatively; 65 patients in laparotomy and 36 in the robotics group. Total incidence of thromboembolism was 4.4% (8/182) during the first six weeks postoperatively. The incidence rate in the laparotomy group was 5.3% (5/95) and in the robotic group was 3.45% (3/87). (P=.72). No statistical significant difference were noted with age (P=.17), BMI (P=.6), race (P=.06), smoking (P=.8), comorbidities (P=.12), stage of cancer (P=.73), or histology (P=.16). Statistical significance was found between two groups respect to mean surgical time (laparotomy: 241 minutes vs robotic: 312 minutes) (P<.001) and blood loss (laparotomy: 477 cc vs Robotic: 101 cc) (P<.001).

CONCLUSION:

The incidence of thromboembolism was not different between robotic surgery and laparotomy. Operative time was longer in robotic group and blood loss was more for laparotomy.

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