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1.
Maturitas ; 144: 4-10, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33358207

RESUMO

OBJECTIVE: To assess the impact of confinement due to the coronavirus (Covid-19) pandemic on health-related quality of life (HRQoL) and resilience in peri- and postmenopausal women. MATERIAL AND METHODS: We used an online questionnaire which was sent between April 30th and May 13th, 2020 to women aged 40-70 years who were peri- or postmenopausal according to STRAW criteria. We used the 16-item Cervantes short-form scale (Cervantes-SF) to measure HRQoL, and the 14-item Wagnild and Young Resilience Scale (RS-14) to measure resilience. High scores on the Cervantes-SF indicate low HRQoL and high scores on the RS-14 indicate high levels of resilience. Covid-19 status, sociodemographic descriptors, and lifestyle variables were also evaluated. RESULTS: We included 2430 peri- and postmenopausal women with valid questionnaires. All items of the Cervantes-SF were completed in 2151 cases, whilst the RS-14 was completed in 2413 cases. There was a negative correlation between scores on the Cervantes-SF and RS-14 scales (Rho -0.350; p < 0.0001). Multiple linear regression analysis revealed a statistically significant association between Cervantes-SF scores and living with others (ß-coefficient -10.2; p < 0.001), use of antidepressants (ß 9.3; p < 0.001), physical activity (ß -8.6; p < 0.001) and sexual activity (ß -2.7; p < 0.001). Resilience was associated with the use of antidepressants (ß -5.9; p < 0.001), physical activity (ß 3.2; p < 0.001) and sexual activity (ß 1.7; p = 0.005). According to the multivariate analysis, there were no associations between either Covid-19 or menopausal status and HRQoL or resilience scores. CONCLUSIONS: During the period of mandatory Covid-19 confinement, peri- and postmenopausal women who engaged in physical and sexual activity had higher HRQoL and higher levels of resilience, whilst women who were using antidepressants had lower HRQoL and lower levels of resilience. HRQoL was greater in women who lived with others.


Assuntos
Perimenopausa/psicologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Quarentena/psicologia , Resiliência Psicológica , Adulto , Idoso , Estudos Transversais , Exercício Físico/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
2.
BMC Womens Health ; 20(1): 277, 2020 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-33371883

RESUMO

OBJECTIVE: To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS: A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS: The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS: Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.


Assuntos
Terapia de Reposição de Estrogênios , Conhecimentos, Atitudes e Prática em Saúde , Menopausa , Estudos Transversais , Feminino , Humanos , Adesão à Medicação/estatística & dados numéricos , Espanha
3.
Menopause ; 27(9): 1047-1052, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32852458

RESUMO

OBJECTIVE: The aim of this study is to evaluate the level of knowledge men have about menopause and to analyze whether sociodemographic aspects influence this knowledge. METHODS: A total of 560 consecutive surveys were collected during 2019. Surveys were completed by men anonymously, voluntarily, and without incentives. A maximum score of 45 points was considered for the knowledge analysis. RESULTS: The mean age was 49.13 ±â€Š11.1 years. The most frequent source of information to obtain knowledge about menopause was friends (61.4%). The mean of the questionnaire score was 20.69 ±â€Š6.1 (R: 0-45). The most frequent symptoms associated with menopause were hot flashes and vaginal dryness (93.7%; 48%) and the best-known treatment to improve vaginal health was lubricants at 69.5%. The most common treatment men knew for improving menopause symptoms was menopause hormone treatment; however, 27.9% of men thought there is no treatment for menopause. Differences were found between ages in numbers and grades (P = 0.032). Men with a higher level of education had significantly more knowledge than those with primary school education (P = 0.016). Differences were shown in men who obtained information from healthcare staff with respect to other sources (P < 0.001). CONCLUSIONS: The level of knowledge in men in this sample is limited. Differences were found between ages, level of education, and sources of information. No differences were found between public and private hospitals. Teaching of this knowledge should be carried out by trained personnel, preferably healthcare staff.

4.
Menopause ; 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32639446

RESUMO

OBJECTIVE: The aim of this study is to evaluate the level of knowledge men have about menopause and to analyze whether sociodemographic aspects influence this knowledge. METHODS: A total of 560 consecutive surveys were collected during 2019. Surveys were completed by men anonymously, voluntarily, and without incentives. A maximum score of 45 points was considered for the knowledge analysis. RESULTS: The mean age was 49.13 ±â€Š11.1 years. The most frequent source of information to obtain knowledge about menopause was friends (61.4%). The mean of the questionnaire score was 20.69 ±â€Š6.1 (R: 0-45). The most frequent symptoms associated with menopause were hot flashes and vaginal dryness (93.7%; 48%) and the best-known treatment to improve vaginal health was lubricants at 69.5%. The most common treatment men knew for improving menopause symptoms was menopause hormone treatment; however, 27.9% of men thought there is no treatment for menopause. Differences were found between ages in numbers and grades (P = 0.032). Men with a higher level of education had significantly more knowledge than those with primary school education (P = 0.016). Differences were shown in men who obtained information from healthcare staff with respect to other sources (P < 0.001). CONCLUSIONS: The level of knowledge in men in this sample is limited. Differences were found between ages, level of education, and sources of information. No differences were found between public and private hospitals. Teaching of this knowledge should be carried out by trained personnel, preferably healthcare staff.

5.
Eur J Obstet Gynecol Reprod Biol ; 252: 43-49, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562940

RESUMO

OBJECTIVES: The aim of the study is to assess whether women who choose to use menopausal hormone therapy (MHT) have lower quality of life (QoL) than those who do not initiate it using Cervantes short form scale (C-SF), and analyze sociodemographic factors associated with lower QoL in women. STUDY DESIGN: A cross-sectional descriptive observational study was made in four hundred and eighty women with climacteric symptoms. RESULTS: Mean age was 51.1 years. Two hundred and sixty-one women (54.3 %) started MHT. The sample´s global mean in C-SF score was 51.3 ± 13.9. Women who choose to use MHT have higher score in C-SF (lower QoL) than women who reject it (58.7 ± 15.9 vs 46.7 ± 12.8; p < 0.001). We found higher score in women with early menopause (53.7 ± 15.9 vs 49.7 ± 13.1; p = 0.037); with no obesity (<30 vs >30 BMI) (52.8 ± 13.5 vs 41.0 ± 8.2; p = 0.002); with previous malignancies (56.2 ± 18.2 vs 50.2 ± 13.5; p = 0.020) and without sexual activity (58.0 ± 25.4 vs 50.4 ± 13.1; p = 0.009. No differences were found in C-SF score with respect to tobacco habits or physical activity. In the multivariate analysis, the variable independently associated to lower QoL by C-SF (high score) was to be a woman who want to initiate MHT (p = 0.004). CONCLUSIONS: Women who choose to use MHT due to menopausal symptoms have lower quality of life measured by C-SF scale. Women with early menopause, with no obesity (<30 BMI), without sexual activity and with previous malignances have lower quality of life measured by C-SF scale. Women with early menopause have more psychic symptoms like nervousness, fatigue and sleep complaints by C-SF scale than women with natural menopause.

6.
J Gynecol Oncol ; 29(1): e1, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29185259

RESUMO

OBJECTIVE: To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC). METHODS: A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1-2; or cervical involvement and grades 1-2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups. RESULTS: Both study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0-275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79-2.28) and OS (HR=0.72; 95% CI=0.42-1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups. CONCLUSION: Systematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.


Assuntos
Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Excisão de Linfonodo , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Neoplasias do Endométrio/economia , Neoplasias do Endométrio/epidemiologia , Feminino , Humanos , Excisão de Linfonodo/efeitos adversos , Excisão de Linfonodo/economia , Excisão de Linfonodo/estatística & dados numéricos , Metástase Linfática , Análise por Pareamento , Pessoa de Meia-Idade , Morbidade , Estadiamento de Neoplasias , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do Tratamento , Neoplasias Uterinas/economia , Neoplasias Uterinas/epidemiologia
7.
Eur J Obstet Gynecol Reprod Biol ; 196: 11-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26651076

RESUMO

OBJECTIVE: To analyze the value of dynamic spectral imaging (DSI) compared to, and as an adjunct to, conventional colposcopy (CC) in the diagnosis of cervical intraepithelial neoplasia (CIN). STUDY DESIGN: Four hundred seventy-nine women referred for colposcopy after an abnormal Pap-smear (≥ASC-US) to the Low Genital Tract Unit of the San Carlos Clinical Hospital in Madrid, Spain during the years 2012-2014 were examined simultaneously by CC and DSI. Thirty-six cases (8.1%) were excluded because the DSI map was not calculated. The gold standard for comparisons was the final histological diagnosis performed by punch biopsy or LEEP. RESULTS: Out of the 443 cases, 293 were found to be negative for CIN, 109 had CIN1 and 41 were found with CIN2+. The sensitivity of CC to detect those with CIN2+ lesions was 73.2% and the specificity 92.3%. Using the DSI map as an adjunct, led to a statistically significant increase of the sensitivity to 87.8% with a concomitant drop in specificity to 85.6%. The adjunctive use of DSI increased the sensitivity for CIN2+ also in the high-risk group of the 65 cases with an identified HPV16/18 infection; CC had a sensitivity of 88.9%, which increased to 100%. The specificity dropped from 91.1% to 87.5%. CONCLUSIONS: Combining conventional colposcopy with DSI mapping improves the capability to detect cervical lesions.


Assuntos
Neoplasia Intraepitelial Cervical/patologia , Colposcopia/métodos , Diagnóstico por Imagem/métodos , Infecções por Papillomavirus/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Estudos Prospectivos , Sensibilidade e Especificidade , Esfregaço Vaginal
8.
Gynecol Obstet Invest ; 78(4): 224-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25402750

RESUMO

BACKGROUND/AIMS: To assess the performance of colposcopists and correlate it with their experience when diagnosing cervical pathology by reviewing conventional colposcopy (CC) digital images and the Dynamic Spectral Imaging System (DySIS) cervical map. METHODS: Images from 50 women with normal and abnormal cervix collected during CC and the corresponding DySIS maps were projected consecutively to 63 participating colposcopists. Participants were asked for their diagnosis (normal, abnormal findings or cancer). The clinical experience of the participants was divided into low (n = 27), medium (n = 18) and high (n = 18), considering the number of colposcopies each one performed routinely. RESULTS: The mean of overall correct diagnoses was significantly higher with DySIS than CC for the low and medium experience group (20.4 vs. 24.4, and 21.9 vs. 26.0, respectively; p < 0.001), but not in the high experience group. The correct diagnosis was significantly higher with DySIS than CC for all experience groups in cases with a normal cervix and cervical intraepithelial neoplasia 2+ (CIN2+), but not for those with CIN1. All groups agreed that DySIS guides biopsies better, offers more information and allows performing colposcopy even without extensive experience. CONCLUSIONS: The results of evaluating projected colposcopy images were more successful with DySIS than with CC in the diagnosis of cervical pathology, especially among less experienced colposcopists.


Assuntos
Competência Clínica , Colposcopia/instrumentação , Colposcopia/normas , Ginecologia , Doenças do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Ácido Acético , Biópsia , Neoplasia Intraepitelial Cervical/patologia , Colposcopia/métodos , Feminino , Humanos , Satisfação do Paciente , Sensibilidade e Especificidade
9.
Rev Esp Enferm Dig ; 106(5): 318-24, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-25287234

RESUMO

BACKGROUND/AIMS: Nausea and vomiting of pregnancy (NVP) impact in the pregnant woman´s quality of life, especially when are persistent or severe. The objective is to estimate the prevalence and factors associated with the persistence of NVP in each trimester of pregnancy. METHODS: We studied a cohort of 263 pregnant women with gestational age < 12 weeks. Data were collected using the Gastro- Esophageal Reflux Questionnaire validated for use in the Spanish population. Data were collected through telephone interviews at the end of each trimester of pregnancy. The main variable was the presence of NVP in each trimester and their persistence along the pregnancy. RESULTS: The prevalence of nausea in the each trimester was 63.5 %, 33.8 %, 26.2 %, and vomiting was 29.3 %, 22.1 %, 14.1 %, respectively. Factors associated with nausea in the first trimester were Latin-American origin (OR: 3.60, 95 %IC 1.61- 80.5) and primary education (OR: 0.31; 0.13-0.73); vomiting was associated with Latin-American origin (OR: 13.80, 1.82-104.4) and was inversely associated with weight gain (OR: 0.58, 0.35-0.97). Persistence of NVP were only associated with suffering the symptom in the previous trimester (p < 0.01), and did not find other predictor factors. CONCLUSIONS: NVP´s prevalence declines along pregnancy, is associated with race and inversely with weight gain, and its persistence over time cannot be predicted.


Assuntos
Êmese Gravídica/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Gravidez , Trimestres da Gravidez , Estudos Prospectivos , Adulto Jovem
10.
Rev. esp. enferm. dig ; 106(5): 318-324, mayo 2014. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-128187

RESUMO

Background/aims: Nausea and vomiting of pregnancy (NVP) impact in the pregnant woman’s quality of life, especially when are persistent or severe. The objective is to estimate the prevalence and factors associated with the persistence of NVP in each trimester of pregnancy. Methods: We studied a cohort of 263 pregnant women with gestational age < 12 weeks. Data were collected using the Gastro- Esophageal Reflux Questionnaire validated for use in the Spanish population. Data were collected through telephone interviews at the end of each trimester of pregnancy. The main variable was the presence of NVP in each trimester and their persistence along the pregnancy. Results: The prevalence of nausea in the each trimester was 63.5 %, 33.8 %, 26.2 %, and vomiting was 29.3 %, 22.1 %, 14.1 %, respectively. Factors associated with nausea in the first trimester were Latin-American origin (OR: 3.60, 95 %IC 1.61- 80.5) and primary education (OR: 0.31; 0.13-0.73); vomiting was associated with Latin-American origin (OR: 13.80, 1.82-104.4) and was inversely associated with weight gain (OR: 0.58, 0.35- 0.97). Persistence of NVP were only associated with suffering the symptom in the previous trimester (p < 0.01), and did not find other predictor factors. Conclusions: NVP’s prevalence declines along pregnancy, is associated with race and inversely with weight gain, and its persistence over time cannot be predicted (AU)


No disponible


Assuntos
Humanos , Feminino , Gravidez , Adulto , Êmese Gravídica/epidemiologia , Êmese Gravídica/prevenção & controle , Hiperêmese Gravídica/epidemiologia , Hiperêmese Gravídica/prevenção & controle , Complicações na Gravidez/epidemiologia , Êmese Gravídica/complicações , Êmese Gravídica/etiologia , Êmese Gravídica/fisiopatologia , Estudos de Coortes , Análise Estatística
11.
Int J Gynecol Cancer ; 24(4): 703-12, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24651627

RESUMO

OBJECTIVE: The aim of this study is to assess the impact of lymphadenectomy (LND) on morbidity, survival, and cost for high-risk histologic types of endometrial cancer (EC). MATERIALS AND METHODS: We analyzed a multicenter retrospective cohort of 389 women with high-risk histotypes of EC (poor differenced tumors [G3], clear cell, serous papillary, and mixed mesodermal tumors) preoperatively confined to the corpus and diagnosed between 2000 and 2013. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched-pair analysis identified 97 pairs (97 with LDN and 97 without) equal in age, body mass index, comorbidities, International Federation of Gynecology and Obstetrics stage, and adjuvant treatment. Demographic data, pathologic examination results, perioperative morbidity, and survival were abstracted from medical records. Cost was provided by the cost unit of the local hospital. Disease-free and overall survival were analyzed using the Kaplan-Meier curves and Cox multivariable regression analysis. RESULTS: Both study groups were homogeneous in demographic data and pathologic examination results. At a median follow-up of 24.5 months (range, 5.4-146.3), disease-free survival (hazard ratio, 1.09; 95% confidence interval, 0.70-1.90) and overall survival (hazard ratio, 0.86; 95% confidence interval, 0.56-1.33) were similar in both groups regardless of nodal count. Positive nodes were found in 23.7%. Predictor factors of nodal involvement were advanced age (P = 0.024), deep myometrial invasion (P < 0.001), and high CA 125 levels (P = 0.003). In the LDN group, operating time, late postoperative complications, and surgical cost were higher (P < 0.05). There were no statistical differences between both groups relative to surgical morbidity. Early postoperative complications and hospital stay were lower in the LDN group. The global cost was similar for both groups (6027&OV0556; for the LND group and 5772&OV0556; for the no-LND group). CONCLUSIONS: Lymphadenectomy in high-risk histotypes of EC does not increase perioperative morbidity or global cost and has not benefit on survival.


Assuntos
Adenocarcinoma de Células Claras/patologia , Adenocarcinoma Mucinoso/patologia , Carcinoma Papilar/patologia , Carcinoma de Células Escamosas/patologia , Cistadenocarcinoma Seroso/patologia , Neoplasias do Endométrio/patologia , Excisão de Linfonodo , Adenocarcinoma de Células Claras/mortalidade , Adenocarcinoma de Células Claras/cirurgia , Adenocarcinoma Mucinoso/mortalidade , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/mortalidade , Carcinoma Papilar/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Terapia Combinada , Cistadenocarcinoma Seroso/mortalidade , Cistadenocarcinoma Seroso/cirurgia , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/cirurgia , Feminino , Seguimentos , Humanos , Histerectomia , Análise por Pareamento , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ovariectomia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
12.
J Minim Invasive Gynecol ; 21(4): 674-81, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24486680

RESUMO

STUDY OBJECTIVE: To compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions. DESIGN: Prospective non-randomized study (Canadian Task Force classification II-2). SETTING: Tertiary center for women's health. PATIENTS: Sixty-two patients with gynecologic cancer operated on by the same surgical team. INTERVENTIONS: Thirty-two patients underwent TIPAL via robotic-assisted laparoscopy, and 30 via conventional laparoscopy. Comparison analyses of perioperative outcomes and estimated costs were performed. MEASUREMENTS AND MAIN RESULTS: There were no differences between robotic-assisted and laparoscopy insofar as age, body mass index, presurgical morbidity, operating time (92.5 minutes for robotics vs 96.6 minutes for laparoscopy), number of aortic nodes (12 vs. 12), hospitalization stay (2 vs. 2 days), or rate of complications (12.5% vs. 13.3%). Blood loss tended to be lower in the robotic group (75.0 vs. 92.5 mL; p = .08). Surgical cost was higher in the robotic group ($3.42 vs. $2.55; p < .001), although hospitalization cost was similar. CONCLUSION: Robotic-assisted and laparoscopy provide similar perioperative outcomes. However, the robotic-assisted approach is associated with higher surgical cost.


Assuntos
Laparoscopia/métodos , Tempo de Internação/estatística & dados numéricos , Excisão de Linfonodo/métodos , Linfonodos/patologia , Neoplasias Ovarianas/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Uterinas/cirurgia , Adulto , Idoso , Aorta Abdominal , Perda Sanguínea Cirúrgica , Feminino , Custos de Cuidados de Saúde , Humanos , Laparoscopia/economia , Tempo de Internação/economia , Excisão de Linfonodo/economia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/patologia , Complicações Pós-Operatórias/economia , Estudos Prospectivos , Procedimentos Cirúrgicos Robóticos/economia , Neoplasias Uterinas/patologia
13.
Eur J Obstet Gynecol Reprod Biol ; 165(2): 289-94, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22819573

RESUMO

OBJECTIVE: To analyze the perioperative outcomes and cost of three surgical approaches in the treatment of endometrial cancer: robotic, laparoscopy and laparotomy. STUDY DESIGN: We studied 347 patients with endometrial cancer treated in a single institution: 71 patients were operated by robotics, 84 by conventional laparoscopy and 192 by laparotomy. All patients underwent total hysterectomy, bilateral salpingoophorectomy and pelvic and para-aortic lymphadenectomy depending on the pathological features. RESULTS: Operative time was longer in the laparoscopy group as compared to robotics and laparotomy (218.2 min, 189.2 min, and 157.4 min respectively, p=0.000). The estimated blood loss was lower in the robotic group relative to the other groups (99.4 ml in robotic, 190.0 ml in laparoscopy and 231.5 ml in laparotomy, p=0.000). Similar findings were observed for the pre- and post-operative mean hemoglobin levels (-1.3g/dl, -2.3g/dl and -2.5 g/dl respectively, p=0.000), and transfusion rate (4.2%, 7.1% and 14.1% respectively, p=0.036). The length of hospital stay was higher in the laparotomy group compared to robotics and laparoscopy (8.1, 3.5 and 4.6 days respectively; p=0.000). The conversion rate to laparotomy was lower for robotics (2.4% for robotics and 8.1% for laparoscopy, p=0.181). Overall complications were similar for robotics and laparoscopy (21.1%, 28.5%) (p=0.079). Robotic complications were significantly lower as compared to laparotomy (21.2 vs 34.9% (p=0.036). No differences were found relative to disease-free or overall survival among the three groups. The global costs were similar for the three approaches (p=0.566). CONCLUSION: Robotics is a safe alternative to laparoscopy and laparotomy for endometrial cancer patients, offering improved perioperative outcomes and similar cost as compared to the other two surgical approaches.


Assuntos
Neoplasias do Endométrio/cirurgia , Laparoscopia/economia , Laparotomia/economia , Robótica/economia , Idoso , Análise Custo-Benefício , Neoplasias do Endométrio/economia , Feminino , Humanos , Histerectomia/economia , Laparotomia/efeitos adversos , Tempo de Internação/economia , Pessoa de Meia-Idade
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