TY - JOUR
T1 - Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison
AU - Perrone, Emanuele
AU - Rossitto, Cristiano
AU - Fanfani, Francesco
AU - Cianci, Stefano
AU - Fagotti, Anna
AU - Uccella, Stefano
AU - Vizzielli, Giuseppe
AU - Vascone, Carmine
AU - Restaino, Stefano
AU - Fedele, Camilla
AU - Saleh, Farrah Layla
AU - Scambia, Giovanni
AU - Gueli Alletti, Salvatore
PY - 2020
Y1 - 2020
N2 - Objective: To evaluate the feasibility of percutaneous approach, we prospectively compared our experience in percutaneous-assisted hysterectomy (PSS-H) with that in a series of laparoscopic hysterectomies (LPS-Hs).
Methods: In this multicentric cohort study, from May 2015 to October 2017, 160 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive surgery (MIS): 80 patients received PSS-H and 80 LPS-H. In each group, 30 cases of low-/intermediate-risk endometrial cancer were enrolled. For both groups, we documented preoperative outcomes, postoperative pain, and cosmetic outcomes.
Results: No statistically significant differences were noted in baseline characteristics or operative time. We observed significant differences in estimated blood loss: median of 50 cc (PSS-H) and 100 cc (LPS-H) (p = 0.0001). In LPS-H, we reported 4 (5.0%) intraoperative complications and 1 (1.3%) in PSS-H. Thirty-day complications were 4 (5%) in PSS-H and 11 (13.8%) in LPS-H (p = 0.058). No significative differences were found in visual analog scale score, despite a relevant disparity in cosmetic outcome (p = 0.0001). For oncological cases, the 2 techniques had comparable intra- and postoperative outcomes and oncological accuracy.
Conclusions: In this study, we reported that PSS-H is comparable to LPS-H for intra- and perioperative outcomes and postoperative pain, while PSS-H seems to be superior in cosmetic outcomes and patient satisfaction. PSS-H may represent a valid alternative in ultra-MIS for benign gynecological conditions and low-/intermediate-risk endometrial cancer.
Keywords: Gynecological surgery; Hysterectomy; Minimally invasive surgery; New technology; Percutaneous approach; Personalized surgical treatment.
AB - Objective: To evaluate the feasibility of percutaneous approach, we prospectively compared our experience in percutaneous-assisted hysterectomy (PSS-H) with that in a series of laparoscopic hysterectomies (LPS-Hs).
Methods: In this multicentric cohort study, from May 2015 to October 2017, 160 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive surgery (MIS): 80 patients received PSS-H and 80 LPS-H. In each group, 30 cases of low-/intermediate-risk endometrial cancer were enrolled. For both groups, we documented preoperative outcomes, postoperative pain, and cosmetic outcomes.
Results: No statistically significant differences were noted in baseline characteristics or operative time. We observed significant differences in estimated blood loss: median of 50 cc (PSS-H) and 100 cc (LPS-H) (p = 0.0001). In LPS-H, we reported 4 (5.0%) intraoperative complications and 1 (1.3%) in PSS-H. Thirty-day complications were 4 (5%) in PSS-H and 11 (13.8%) in LPS-H (p = 0.058). No significative differences were found in visual analog scale score, despite a relevant disparity in cosmetic outcome (p = 0.0001). For oncological cases, the 2 techniques had comparable intra- and postoperative outcomes and oncological accuracy.
Conclusions: In this study, we reported that PSS-H is comparable to LPS-H for intra- and perioperative outcomes and postoperative pain, while PSS-H seems to be superior in cosmetic outcomes and patient satisfaction. PSS-H may represent a valid alternative in ultra-MIS for benign gynecological conditions and low-/intermediate-risk endometrial cancer.
Keywords: Gynecological surgery; Hysterectomy; Minimally invasive surgery; New technology; Percutaneous approach; Personalized surgical treatment.
KW - Gynecological surgery
KW - Hysterectomy
KW - Minimally invasive surgery
KW - New technology
KW - Percutaneous approach
KW - Personalized surgical treatment
KW - Gynecological surgery
KW - Hysterectomy
KW - Minimally invasive surgery
KW - New technology
KW - Percutaneous approach
KW - Personalized surgical treatment
UR - http://hdl.handle.net/10807/167183
U2 - 10.1159/000509877
DO - 10.1159/000509877
M3 - Article
SN - 0378-7346
VL - 85
SP - 318
EP - 326
JO - Gynecologic and Obstetric Investigation
JF - Gynecologic and Obstetric Investigation
ER -