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

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• 作者：David E. Cohn ; MD^a ; Karina Castellon-Larios ; MD^b ; ^{Karina.CastellonLarios@osumc.edu" class="auth_mail" title="E-mail the corresponding author} ; Laura Huffman ; MD^a ; Ritu Salani ; MD^a ; Jeffrey M. Fowler ; MD^a ; Larry J. Copeland ; MD^a ; David M. O'Malley ; MD^a ; Floor J. Backes ; MD^a ; Eric L. Eisenhauer ; MD^a ; Mahmoud Abdel-Rasoul ; MPH^c ; Erika G. Puente ; MD^b ; Sergio D. Bergese ; MD^b
• 关键词：Endometrial cancer ; Laparotomy ; Postoperative pain ; Quality of recovery ; Robotic surgery
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：March-April 2016
• 年：2016
• 卷：23
• 期：3
• 页码：429-434
• 全文大小：652 K

文摘

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.