Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study

Abstract Introduction The objective of the study was to provide a comprehensive description of perioperative morbidity associated with robot‐assisted surgery (RAS) in a gynecological oncology setting in order to improve the preoperative counseling of women and support shared decision‐making. Materia...

Full description

Saved in:
Bibliographic Details
Main Authors: Algirdas Markauskas, Jan Blaakær, Koen Josef Traen, Gudrun Astrid Neumann, Wu Chunsen, Lone Kjeld Petersen
Format: Article
Language:English
Published: Wiley 2024-08-01
Series:Acta Obstetricia et Gynecologica Scandinavica
Subjects:
Online Access:https://doi.org/10.1111/aogs.14852
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850211588347265024
author Algirdas Markauskas
Jan Blaakær
Koen Josef Traen
Gudrun Astrid Neumann
Wu Chunsen
Lone Kjeld Petersen
author_facet Algirdas Markauskas
Jan Blaakær
Koen Josef Traen
Gudrun Astrid Neumann
Wu Chunsen
Lone Kjeld Petersen
author_sort Algirdas Markauskas
collection DOAJ
description Abstract Introduction The objective of the study was to provide a comprehensive description of perioperative morbidity associated with robot‐assisted surgery (RAS) in a gynecological oncology setting in order to improve the preoperative counseling of women and support shared decision‐making. Material and Methods All women scheduled for intended RAS between January 2015 and December 2022 were prospectively included in an electronic morbidity database for the analyses of perioperative complications. Results In total, 2225 women were included. Sixty‐four patients (2.9%) experienced an intraoperative complication. Intraoperative complications were associated with a higher rate of conversion to laparotomy (15.6% vs. 1.8%, p < 0.001), a higher rate of major postoperative morbidity (9.3% vs. 2.4%, p < 0.001), and a higher rate of reoperation (9.3% vs. 1.7%, p < 0.001), compared to cases without intraoperative complications. Thirty‐day postoperative morbidity was evaluated according to the Memorial Sloan‐Kettering Cancer Center Surgical Secondary Events Grading System. Grade 3–5 events were considered major. A total of 57 patients (2.6%) experienced a major event after surgery, postoperative rupture of the vaginal vault being the most common complication requiring surgical intervention. Conversion to laparotomy occurred in 49 cases (2.2%) and was associated with higher intraoperative blood loss (300 mL vs. 25 mL, p < 0.001), a higher rate of postoperative major events (20.4% vs. 2.2%, p < 0.001), and a higher rate of reoperation (11.8% vs. 1.6%, p < 0.001). Conclusions Our study demonstrates low rates of major perioperative morbidity and conversion to laparotomy after RAS performed by trained high‐volume surgeons in a gynecological oncology setting.
format Article
id doaj-art-761d792d2114415bafaed128520aaae4
institution OA Journals
issn 0001-6349
1600-0412
language English
publishDate 2024-08-01
publisher Wiley
record_format Article
series Acta Obstetricia et Gynecologica Scandinavica
spelling doaj-art-761d792d2114415bafaed128520aaae42025-08-20T02:09:31ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-08-0110381672167910.1111/aogs.14852Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort studyAlgirdas Markauskas0Jan Blaakær1Koen Josef Traen2Gudrun Astrid Neumann3Wu Chunsen4Lone Kjeld Petersen5Department of Gynecology and Obstetrics Odense University Hospital Odense DenmarkDepartment of Gynecology and Obstetrics Odense University Hospital Odense DenmarkDepartment of Gynecology and Obstetrics Odense University Hospital Odense DenmarkDepartment of Gynecology and Obstetrics Odense University Hospital Odense DenmarkResearch Unit, Department of Clinical Research in Gynecology and Obstetrics University of Southern Denmark Odense DenmarkDepartment of Gynecology and Obstetrics Odense University Hospital Odense DenmarkAbstract Introduction The objective of the study was to provide a comprehensive description of perioperative morbidity associated with robot‐assisted surgery (RAS) in a gynecological oncology setting in order to improve the preoperative counseling of women and support shared decision‐making. Material and Methods All women scheduled for intended RAS between January 2015 and December 2022 were prospectively included in an electronic morbidity database for the analyses of perioperative complications. Results In total, 2225 women were included. Sixty‐four patients (2.9%) experienced an intraoperative complication. Intraoperative complications were associated with a higher rate of conversion to laparotomy (15.6% vs. 1.8%, p < 0.001), a higher rate of major postoperative morbidity (9.3% vs. 2.4%, p < 0.001), and a higher rate of reoperation (9.3% vs. 1.7%, p < 0.001), compared to cases without intraoperative complications. Thirty‐day postoperative morbidity was evaluated according to the Memorial Sloan‐Kettering Cancer Center Surgical Secondary Events Grading System. Grade 3–5 events were considered major. A total of 57 patients (2.6%) experienced a major event after surgery, postoperative rupture of the vaginal vault being the most common complication requiring surgical intervention. Conversion to laparotomy occurred in 49 cases (2.2%) and was associated with higher intraoperative blood loss (300 mL vs. 25 mL, p < 0.001), a higher rate of postoperative major events (20.4% vs. 2.2%, p < 0.001), and a higher rate of reoperation (11.8% vs. 1.6%, p < 0.001). Conclusions Our study demonstrates low rates of major perioperative morbidity and conversion to laparotomy after RAS performed by trained high‐volume surgeons in a gynecological oncology setting.https://doi.org/10.1111/aogs.14852cervical cancerendometrial cancerhysterectomymorbiditymortalityoncology
spellingShingle Algirdas Markauskas
Jan Blaakær
Koen Josef Traen
Gudrun Astrid Neumann
Wu Chunsen
Lone Kjeld Petersen
Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
Acta Obstetricia et Gynecologica Scandinavica
cervical cancer
endometrial cancer
hysterectomy
morbidity
mortality
oncology
title Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
title_full Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
title_fullStr Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
title_full_unstemmed Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
title_short Morbidity following robot‐assisted surgery in a gynecological oncology setting: A cohort study
title_sort morbidity following robot assisted surgery in a gynecological oncology setting a cohort study
topic cervical cancer
endometrial cancer
hysterectomy
morbidity
mortality
oncology
url https://doi.org/10.1111/aogs.14852
work_keys_str_mv AT algirdasmarkauskas morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy
AT janblaakær morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy
AT koenjoseftraen morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy
AT gudrunastridneumann morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy
AT wuchunsen morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy
AT lonekjeldpetersen morbidityfollowingrobotassistedsurgeryinagynecologicaloncologysettingacohortstudy