Fewer Complications After MIRS Introduced for Endometrial Cancer
MONDAY, March 18, 2019 -- The introduction of minimally invasive robotic surgery (MIRS) is associated with a significantly lower risk for severe complications among patients with early-stage endometrial cancer, according to a study published online Feb. 27 in JAMA Surgery.
Siv Lykke Jørgensen, M.D., from Odense University Hospital in Denmark, and colleagues used data from the Danish Gynecological Cancer Database to identify 5,654 women with early-stage endometrial cancer who underwent surgery from Jan. 1, 2005, to June 30, 2015. Outcome comparisons were made among women undergoing surgery before (3,091 patients; group 1) and after (2,563 patients; group 2) introduction of MIRS.
The researchers found that the odds of severe complications were significantly higher in group 1 than in group 2 (odds ratio [OR], 1.39; 95 percent confidence interval, 1.11 to 1.74). In group 1, 14.1 percent of women underwent minimally invasive laparoscopic surgery (MILS) versus 22.2 percent in group 2. In group 2, 50 percent of women underwent MIRS. A total abdominal hysterectomy was associated with increased odds of severe complications versus MILS (OR, 2.58; 95 percent confidence interval, 1.8 to 3.7) and MIRS (OR, 3.87; 95 percent confidence interval, 2.52 to 5.93) in group 2. However, there was no difference in severe complications for MILS versus MIRS (OR, 1.5; 95 percent confidence interval, 0.99 to 2.27).
"The national introduction of MIRS changed the surgical approach for early-stage endometrial cancer from open surgery to minimally invasive surgery," the authors write. "This change in surgical approach was associated with a significantly reduced risk of severe complications."
The study was supported in part by the Program for Clinical Research Infrastructure, which was established by the Lundbeck Foundation and the Novo Nordisk Foundation.
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Posted: March 2019