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

摘要: BACKGROUND For early-stage cervical cancers, radical hysterectomy (RH) with pelvic lymphadenectomy has been the standard care. This study compared learning curves and intra-, peri-, post-operative outcomes for 3-dimensional laparoscopic RH (3D-LRH) robotic-assisted (RA)-LRH by a surgeon highly skilled in 2-dimensional (2D)-LRH treatment of cancer. MATERIAL AND METHODS Two hundred thirty-nine patients cancer (FIGO stage: Ia2-IIa2) admitted to Shanghai Obstetrics Gynecology Hospital, Fudan University were recruited into this prospective study: 54, 85, 100 underwent 2D-, 3D-, RA-LRH, respectively followed up. Patients' demographic, clinical, operative information was retrieved compared. CUSUM (cumulative summation) analysis using benchmark derived from previously performed 2D-LRHs. RESULTS Both 3D- RA-LRH had steep curve. 3D-LRH superior 2D- terms significantly shorter operating time. all approaches, time associated uterus size patient not affected other parameters. All approaches LRH yielded comparable radicality results than CONCLUSIONS similar radicality, intra-operative complication rates, however, shortest lowest amount blood loss. After reaching proficiency, that 2D-LRH, might be even cases where acquired more experience. In countries labor costs are low; preferable