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.

Perrone, E., Rossitto, C., Fanfani, F., Cianci, S., Fagotti, A., Uccella, S., Vizzielli, G., Vascone, C., Restaino, S., Fedele, C., Saleh, F. L., Scambia, G., Gueli Alletti, S., Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison, <<GYNECOLOGIC AND OBSTETRIC INVESTIGATION>>, 2020; 85 (4): 318-326. [doi:10.1159/000509877] [http://hdl.handle.net/10807/167183]

Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Emanuele; Rossitto;Cristiano; Fanfani;Francesco; Cianci;Stefano; Fagotti;Stefano; Vizzielli;Stefano; Fedele;Farrah Layla; Scambia;Giovanni; Gueli Alletti
2020

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.
Inglese
Perrone, E., Rossitto, C., Fanfani, F., Cianci, S., Fagotti, A., Uccella, S., Vizzielli, G., Vascone, C., Restaino, S., Fedele, C., Saleh, F. L., Scambia, G., Gueli Alletti, S., Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison, <<GYNECOLOGIC AND OBSTETRIC INVESTIGATION>>, 2020; 85 (4): 318-326. [doi:10.1159/000509877] [http://hdl.handle.net/10807/167183]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/167183
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 4
social impact