Robotic Surgery in Elderly and Very Elderly Gynecologic Cancer Patients.
J Minim Invasive Gynecol
; 25(5): 872-877, 2018.
Article
em En
| MEDLINE
| ID: mdl-29339300
ABSTRACT
STUDY OBJECTIVE:
To investigate the feasibility, safety, and short-term outcomes of robotic surgery (RS) for gynecologic oncologic indications (cervical, endometrial, and ovarian cancer) in elderly patients, especially women age 65 to 74 years (elderly group [EG]) compared with women age ≥75 years (very elderly group [VEG]).DESIGN:
Retrospective cohort study (Canadian Task Force classification II-2).SETTING:
Catholic University of the Sacred Heart, Rome, Italy. PATIENTS Between May 2013 and April 2017, 204 elderly and very elderly patients underwent RS procedures for gynecologic malignancies.RESULTS:
The median age was 71 years (range, 65-74 years) in the EG and 77 years (range, 75-87 years) in the VEG. The incidence of cardiovascular disease was higher in the VEG (p = .038). The EG and VEG were comparable in terms of operative time, blood loss, and need for blood transfusion. Almost all (98.5%) of the patients underwent total/radical hysterectomy, 109 patients (55.6% of the EG vs 48.3% of the VEG) underwent pelvic lymphadenectomy, and 19 patients (10.5% of the EG vs 6.7% of the VEG) underwent aortic lymphadenectomy. A total of 7 (3.4%) conversions to open surgery were registered. Only 3 patients required postoperative intensive care unit admission. The median length of hospital stay was 2 days in each group. A total of 11 patients (5.6%) had early postoperative complications. Four patients (2.8%) in the EG and 2 patients (3.3%) in the VEG experienced grade ≥2 complications. At the time of analysis, median follow-up was 18 months (range, 6-55 months). Eleven patients (5.6%) experienced disease relapse, 2 (1%) died of disease, and 3 (1.5%) died of cardiovascular disease.CONCLUSIONS:
This study demonstrates the feasibility, safety, and good short-term outcomes of RS in elderly and very elderly gynecologic cancer patients. No patient can be considered too old for a minimally invasive robotic approach, but a multidisciplinary approach is the best management pathway; efforts to reduce associated morbidity are essential.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
/
Procedimentos Cirúrgicos Robóticos
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Neoplasias dos Genitais Femininos
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Histerectomia
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Excisão de Linfonodo
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article