A Prospective, Comparative Study for the Evaluation of Postoperative Pain and Quality of Recovery in Patients Undergoing Robotic Versus Open Hysterectomy for Staging of Endometrial Cancer.
Cohn DE, Castellon-Larios K, Huffman L, Salani R, Fowler JM, Copeland LJ, O'Malley DM, Backes FJ, Eisenhauer EL, Abdel-Rasoul M, Puente EG, Bergese SD
J Minim Invasive Gynecol 23 429-34 03/01/2016
STUDY OBJECTIVE: To measure and compare postoperative pain and patient satisfaction in patients undergoing either robotic or open laparotomy for surgical staging of endometrial cancer.
DESIGN: Prospective, comparative study (Canadian Task Force classification II).
SETTING: University hospital.
PATIENTS: A total of 142 patients undergoing either robotic or open laparotomy for surgical staging of endometrial cancer.
INTERVENTIONS: Patients scheduled for surgical staging of endometrial cancer at a single institution were identified. The patients underwent either robotic or open hysterectomy for staging of endometrial cancer. The choice of operative approach (robotic vs laparotomy) was made by the faculty physician before enrollment. Patients participated in the study for up to 48 hours for pain assessments and up to 10 ± 3 days postoperatively for quality of recovery assessments.
MEASUREMENTS AND MAIN RESULTS: The following measurements were performed: postoperative pain with the visual analog scale (VAS), 24-hour opioid consumption, and quality of recovery using the Quality of Recovery Questionnaire (QoR-40). The study was terminated owing to futility, given the lack of open procedures at our institution. Despite that lack of statistically significant difference between VAS scores at rest and with leg extension, there was a significant decrease in 24-hour opioid consumption in the robotic group. In addition, the QoR-40 showed an increased perception of recovery in patients within the robotic group compared with the laparotomy group.
CONCLUSION: Patients with endometrial cancer who underwent robotic surgery had decreased postoperative opioid consumption and improved quality of recovery compared with those who underwent surgery via laparotomy.