Minimally-Invasive Robotic Hysterectomy for Early Cervical Cancer is Associated with Shorter Hospital Stays and Less Pain Medication than Laparoscopy

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(ChemotherapyAdvisor) – Among women with early cervical cancer undergoing minimally-invasive radical hysterectomy, robotic radical hysterectomy is associated with shorter hospital stays and lower administered doses of opioids for pain management than laparoscopic surgery, according to a study published in the Annals of Surgical Oncology.

The study's “preliminary data show that the robotic approach to radical hysterectomy and pelvic lymphadenectomy resulted in a significant decrease in intravenous opioid requirements compared to total laparoscopic radical hysterectomy,” reported Pamela T. Soliman, MD, MPH, of the Department of Gynecologic Oncology at the University of Texas MD Anderson Cancer Center in Houston, Texas, and coauthors. However, they reported, there was no difference in visual pain scores for the two groups.

The authors reviewed medication histories for all women with cervical cancer who underwent pelvic lymph node dissection and either laparoscopic radical hysterectomy (n=55) or robotic radical hysterectomy (n=30) during 2004 to 2010.

More intravenous opioids were administered to patients undergoing laparoscopy than those undergoing robotic surgery (26.7 mg morphine equivalents vs 10.7 mg morphine equivalents; P=0.001), the authors reported – despite the absence of a significant difference in visual pain scores or antiemetics between the two groups.

Length of stay was significantly longer among patients undergoing laparoscopy than those undergoing robotic surgery (2 vs 1 day; P=0.005), but longer hospital stays did not explain this group's greater total use of opioids; the median rate of intravenous analgesic use between laparoscopy patients (15.7 mg/day) exceeded the rate among robotic surgery patients (9.5 mg/day; P=0.017).

“In order to fully understand the differences in both medical outcomes, as well as quality of life, these surgical approaches will have to be compared in a prospective randomized fashion that use validated measures,” they wrote.

The study was funded by the US National Cancer Institute (NCI).


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