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08 August 2019 : Clinical Research  

Concurrent Learning Curves of 3-Dimensional and Robotic-Assisted Laparoscopic Radical Hysterectomy for Early-Stage Cervical Cancer Using 2-Dimensional Laparoscopic Radical Hysterectomy as a Benchmark: A Single Surgeon’s Experience

Ding Ding1BCEF, Hongyuan Jiang1BCF, Jichan Nie1B, Xishi Liu12ABCEG*, Sun-Wei Guo12ACEFG

DOI: 10.12659/MSM.914952

Med Sci Monit 2019; 25:5903-5919


BACKGROUND: For early-stage cervical cancers, radical hysterectomy (RH) with pelvic lymphadenectomy has been the standard care. This study compared the learning curves and intra-, peri-, and post-operative outcomes for 3-dimensional laparoscopic RH (3D-LRH) and robotic-assisted (RA)-LRH by a surgeon highly skilled in 2-dimensional (2D)-LRH for treatment of early-stage cervical cancer.

MATERIAL AND METHODS: Two hundred and thirty-nine patients with early-stage cervical cancer (FIGO stage: Ia2–IIa2) admitted to Shanghai Obstetrics and Gynecology Hospital, Fudan University were recruited into this prospective study: 54, 85, and 100 patients underwent 2D-, 3D-, and RA-LRH, respectively and were followed up. Patients’ demographic, clinical, and operative information was retrieved and compared. CUSUM (cumulative summation) analysis using a benchmark derived from previously performed 2D-LRHs.

RESULTS: Both 3D- and RA-LRH had a steep learning curve. 3D-LRH was superior to 2D- and RA-LRH in terms of significantly shorter operating time. For all approaches, the operating time was associated with the uterus size of the patient and was not affected by other parameters. All approaches of LRH yielded comparable radicality and operative results other than operative time.

CONCLUSIONS: Both 3D- and RA-LRH approaches had similar radicality, and intra-operative and post-operative complication rates, however, 3D-LRH had the shortest operating time and lowest amount of blood loss. After reaching proficiency, RA-LRH had comparable operating time with that of 2D-LRH, and might be even shorter in cases where surgeon has acquired more experience. In countries where labor costs are low; 3D-LRH might be preferable to 2D- and RA-LRH for early-stage cervical cancer.

Keywords: Hysterectomy, Laparoscopes, Robotics



01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Dinah V. Parums
Scientific Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.935624

Med Sci Monit 2021; 27:e935624


03 December 2021 : Laboratory Research  

Influenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...

Med Sci Monit In Press; DOI: 10.12659/MSM.934862  

08 November 2021 : Database Analysis  

Virtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...

Med Sci Monit In Press; DOI: 10.12659/MSM.934102  

01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Med Sci Monit 2021; 27:e935624

In Press

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A Review of the Impact of Neutrophils and Neutrophil Extracellular Traps (NETs) on the Development of Aorti...

Med Sci Monit In Press; DOI: 10.12659/MSM.935134  

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Adie’s Pupil: A Diagnostic Challenge for the Physician

Med Sci Monit In Press; DOI: 10.12659/MSM.934657  

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Astragalus Flavone Induces Proliferation and Differentiation of Neural Stem Cells in a Cerebral Infarction ...

Med Sci Monit In Press; DOI: 10.12659/MSM.933830  

06 Dec 2021 : Clinical Research  

Alteration of Serum Metabolites in Women of Reproductive Age with Chronic Constipation

Med Sci Monit In Press; DOI: 10.12659/MSM.934117  

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750