Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Francesco Fanfani, Anna Fagotti, Giovanni Scambia, Cristiano Rossitto, Stefano Cianci, Giuseppe Vizzielli, Camilla Fedele, Salvatore Gueli Alletti, Emanuele Perrone, Stefano Uccella, Carmine Vascone, Stefano Restaino, Farrah Layla Saleh

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

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.
Lingua originaleEnglish
pagine (da-a)318-326
Numero di pagine9
RivistaGynecologic and Obstetric Investigation
Volume85
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Gynecological surgery
  • Hysterectomy
  • Minimally invasive surgery
  • New technology
  • Percutaneous approach
  • Personalized surgical treatment

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