Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre
Royal Surrey NHS Foundation Trust introduced robotic surgery for uterine corpus cancer in 2010 to support increased access to minimally invasive surgery, a central element of an enhanced recovery after surgery (ERAS) pathway. More than 1750 gynaecological oncology robotic procedures have now been pe...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/21/5463 |
| _version_ | 1797468802785476608 |
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| author | Christina Uwins Radwa Hablase Hasanthi Assalaarachchi Anil Tailor Alexandra Stewart Jayanta Chatterjee Patricia Ellis Simon S. Skene Agnieszka Michael Simon Butler-Manuel |
| author_facet | Christina Uwins Radwa Hablase Hasanthi Assalaarachchi Anil Tailor Alexandra Stewart Jayanta Chatterjee Patricia Ellis Simon S. Skene Agnieszka Michael Simon Butler-Manuel |
| author_sort | Christina Uwins |
| collection | DOAJ |
| description | Royal Surrey NHS Foundation Trust introduced robotic surgery for uterine corpus cancer in 2010 to support increased access to minimally invasive surgery, a central element of an enhanced recovery after surgery (ERAS) pathway. More than 1750 gynaecological oncology robotic procedures have now been performed at Royal Surrey NHS Foundation Trust. A retrospective cohort study was performed of patients undergoing surgery for uterine corpus cancer between the 1 January 2010 and the 31 December 2019 to evaluate its success. Data was extracted from the dedicated gynaecological oncology database and a detailed notes review performed. During this time; 952 patients received primary surgery for uterine corpus cancer; robotic: <i>n</i> = 734; open: <i>n</i> = 164; other minimally invasive surgery: <i>n</i> = 54. The introduction of the Da Vinci<sup>TM</sup> robot to Royal Surrey NHS Foundation Trust was associated with an increase in the minimally invasive surgery rate. Prior to the introduction of robotic surgery in 2008 the minimally invasive surgery (MIS) rate was 33% for women with uterine corpus cancer undergoing full surgical staging. In 2019, 10 years after the start of the robotic surgery program 91.3% of women with uterine corpus cancer received robotic surgery. Overall the MIS rate increased from 33% in 2008 to 92.9% in 2019. Robotic surgery is associated with a low 30-day mortality (0.1%), low return to theatre (0.5%), a low use of blood transfusion and intensive care (1.8% & 7.2% respectively), low conversion to open surgery (0.5%) and a reduction in median length of stay from 6 days (in 2008) to 1 day, regardless of age/BMI. Robotic survival is consistent with published data. Introduction of the robotic program for the treatment of uterine cancer increased productivity and was associated with a highly predicable patient pathway of care, for high-risk patients, with reduced demands on health services. Future health care commissioning should further expand access to robotic surgery nationally for women with uterine corpus cancer. |
| first_indexed | 2024-03-09T19:12:32Z |
| format | Article |
| id | doaj.art-c12515c3cc814b679245c91283d251d0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T19:12:32Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c12515c3cc814b679245c91283d251d02023-11-24T04:04:48ZengMDPI AGCancers2072-66942022-11-011421546310.3390/cancers14215463Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer CentreChristina Uwins0Radwa Hablase1Hasanthi Assalaarachchi2Anil Tailor3Alexandra Stewart4Jayanta Chatterjee5Patricia Ellis6Simon S. Skene7Agnieszka Michael8Simon Butler-Manuel9Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKSwansea Gynaecological Oncology Centre (SGOC), Swansea Bay University Health board, Singleton Hospital, Swansea SA2 8QA, UKAcademic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKAcademic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKSt. Luke’s Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKAcademic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKAcademic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKSurrey Clinical Trials Unit, University of Surrey, Guildford GU2 7XP, UKSt. Luke’s Cancer Centre, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKAcademic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UKRoyal Surrey NHS Foundation Trust introduced robotic surgery for uterine corpus cancer in 2010 to support increased access to minimally invasive surgery, a central element of an enhanced recovery after surgery (ERAS) pathway. More than 1750 gynaecological oncology robotic procedures have now been performed at Royal Surrey NHS Foundation Trust. A retrospective cohort study was performed of patients undergoing surgery for uterine corpus cancer between the 1 January 2010 and the 31 December 2019 to evaluate its success. Data was extracted from the dedicated gynaecological oncology database and a detailed notes review performed. During this time; 952 patients received primary surgery for uterine corpus cancer; robotic: <i>n</i> = 734; open: <i>n</i> = 164; other minimally invasive surgery: <i>n</i> = 54. The introduction of the Da Vinci<sup>TM</sup> robot to Royal Surrey NHS Foundation Trust was associated with an increase in the minimally invasive surgery rate. Prior to the introduction of robotic surgery in 2008 the minimally invasive surgery (MIS) rate was 33% for women with uterine corpus cancer undergoing full surgical staging. In 2019, 10 years after the start of the robotic surgery program 91.3% of women with uterine corpus cancer received robotic surgery. Overall the MIS rate increased from 33% in 2008 to 92.9% in 2019. Robotic surgery is associated with a low 30-day mortality (0.1%), low return to theatre (0.5%), a low use of blood transfusion and intensive care (1.8% & 7.2% respectively), low conversion to open surgery (0.5%) and a reduction in median length of stay from 6 days (in 2008) to 1 day, regardless of age/BMI. Robotic survival is consistent with published data. Introduction of the robotic program for the treatment of uterine cancer increased productivity and was associated with a highly predicable patient pathway of care, for high-risk patients, with reduced demands on health services. Future health care commissioning should further expand access to robotic surgery nationally for women with uterine corpus cancer.https://www.mdpi.com/2072-6694/14/21/5463endometrial cancerrobotic surgeryDa VinciERASuterine cancerminimally invasive surgery |
| spellingShingle | Christina Uwins Radwa Hablase Hasanthi Assalaarachchi Anil Tailor Alexandra Stewart Jayanta Chatterjee Patricia Ellis Simon S. Skene Agnieszka Michael Simon Butler-Manuel Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre Cancers endometrial cancer robotic surgery Da Vinci ERAS uterine cancer minimally invasive surgery |
| title | Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre |
| title_full | Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre |
| title_fullStr | Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre |
| title_full_unstemmed | Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre |
| title_short | Enhanced Recovery after Uterine Corpus Cancer Surgery: A 10 Year Retrospective Cohort Study of Robotic Surgery in an NHS Cancer Centre |
| title_sort | enhanced recovery after uterine corpus cancer surgery a 10 year retrospective cohort study of robotic surgery in an nhs cancer centre |
| topic | endometrial cancer robotic surgery Da Vinci ERAS uterine cancer minimally invasive surgery |
| url | https://www.mdpi.com/2072-6694/14/21/5463 |
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