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, Stefano Uccella, Carmine Vascone, 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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