دورية أكاديمية
The Influence of Surgical Complexity and Center Experience on Postoperative Morbidity After Minimally Invasive Surgery in Gynecologic Oncology: Lessons Learned from the ROBOGYN-1004 Trial.
العنوان: | The Influence of Surgical Complexity and Center Experience on Postoperative Morbidity After Minimally Invasive Surgery in Gynecologic Oncology: Lessons Learned from the ROBOGYN-1004 Trial. |
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المؤلفون: | Lambaudie E; Paoli Calmettes Institute, Marseille, France., Bogart E; Oscar Lambret Cancer Center, Lille, France., Le Deley MC; Oscar Lambret Cancer Center, Lille, France.; Université Paris-Sud, UVSQ, CESP, INSERM, Université Paris-Saclay, Villejuif, France., El Hajj H; Paoli Calmettes Institute, Marseille, France. Houssein-elhajj@outlook.com.; Oscar Lambret Cancer Center, Lille, France. Houssein-elhajj@outlook.com., Gauthier T; University Hospital-Limoges, Limoges, France., Hebert T; University Hospital-Tours, Tours, France., Collinet P; University Hospital-Lille, Lille, France., Classe JM; Institut de Cancérologie de l'Ouest-Nantes, Nantes, France., Lecuru F; Curie Institute, Paris, France., Motton S; University Hospital-Toulouse, Toulouse, France., Conri V; University Hospital-Bordeaux, Bordeaux, France., Ferrer C; University Hospital-Nîmes, Nîmes, France., Marchal F; CRAN, UMR 7039, CNRS Institut de Cancérologie de Lorraine Vandoeuvre les-Nancy, Université de Lorraine, Nancy, France., Ferron G; Institut Claudius Regaud Cancer Center-Toulouse, Toulouse, France., Probst A; Oscar Lambret Cancer Center, Lille, France., Jauffret C; Paoli Calmettes Institute, Marseille, France., Narducci F; Oscar Lambret Cancer Center, Lille, France. |
المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Jul; Vol. 31 (7), pp. 4566-4575. Date of Electronic Publication: 2024 Apr 15. |
نوع المنشور: | Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
مواضيع طبية MeSH: | Genital Neoplasms, Female*/surgery , Laparoscopy*/adverse effects , Laparoscopy*/methods , Postoperative Complications*/etiology , Robotic Surgical Procedures*/adverse effects , Robotic Surgical Procedures*/methods, Adult ; Aged ; Female ; Humans ; Middle Aged ; Follow-Up Studies ; Gynecologic Surgical Procedures/methods ; Gynecologic Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/methods ; Morbidity ; Prognosis |
مستخلص: | Background: This study was a secondary analysis of the ROBOGYN-1004 trial conducted between 2010 and 2015. The study aimed to identify factors that affect postoperative morbidity after either robot-assisted laparoscopy (RL) or conventional laparoscopy (CL) in gynecologic oncology. Methods: The study used two-level logistic regression analyses to evaluate the prognostic and predictive value of patient, surgery, and center characteristics in predicting severe postoperative morbidity 6 months after surgery. Results: This analysis included 368 patients. Severe morbidity occurred in 49 (28 %) of 176 patients who underwent RL versus 41 (21 %) of 192 patients who underwent CL (p = 0.15). In the multivariate analysis, after adjustment for the treatment group (RL vs CL), the risk of severe morbidity increased significantly for patients who had poorer performance status, with an odds ratio (OR) of 1.62 for the 1-point difference in the WHO performance score (95 % CI 1.06-2.47; p = 0.027) and according to the type of surgery (p < 0.001). A focus on complex surgical acts showed significant more morbidity in the RL group than in the CL group at the less experienced centers (OR, 3.31; 95 % CI 1.0-11; p = 0.05) compared with no impact at the experienced centers (OR, 0.87; 95 % CI 0.38-1.99; p = 0.75). Conclusion: The findings suggest that the center's experience may have an impact on the risk of morbidity for patients undergoing complex robot-assisted surgical procedures. (© 2024. The Author(s).) |
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معلومات مُعتمدة: | INCa-PHRC-2010 Institut National Du Cancer |
فهرسة مساهمة: | Keywords: Conventional laparoscopy; Gynecologic oncology; Morbidity; Prognostics factors; Randomized phase III trial; Robotic-assisted laparoscopy |
تواريخ الأحداث: | Date Created: 20240414 Date Completed: 20240613 Latest Revision: 20240710 |
رمز التحديث: | 20240710 |
مُعرف محوري في PubMed: | PMC11164758 |
DOI: | 10.1245/s10434-024-15265-1 |
PMID: | 38616209 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1534-4681 |
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DOI: | 10.1245/s10434-024-15265-1 |