Hand-Assisted Robotic Surgery for Staging of XXXX With High Risk of Peritoneal Spread: A Retrospective Cohort Study.

@entity43 @entity1 @entity1204 @entity5 @entity190 @entity1104
OBJECTIVE: This study aimed to determine surgical outcomes related to @entity1104 ( @entity1104 ) for staging of @entity43 and @entity5 with high risk of peritoneal spread and compare them to laparotomy and standard robotic-assisted surgery. METHODS: A retrospective cohort study of @entity1 undergoing staging for uterine and @entity43 between January 2011 and July 2013 at a major metropolitan teaching hospital was reviewed. @entity1 undergoing @entity1104 were matched with @entity1 undergoing staging laparotomy [exploratory laparotomy (XLAP)] for the same indications and with @entity1 undergoing traditional @entity1104 ( @entity1104 ) for staging of endometrioid @entity1204 . In @entity1104 , a longer incision is used to allow palpation of the peritoneal surfaces, to exteriorize the small bowel, to examine the mesentery, and to perform omentectomy. RESULTS: One hundred five @entity1 were analyzed (15 @entity1104 , 45 @entity1104 , 45 XLAP). Compared with XLAP, @entity1104 was associated with decreased @entity190 (200 vs 400 mL, P = 0.011) and shorter hospital stay (1 vs 4 days, P < 0.001). @entity1 who had undergone @entity1104 had fewer major complications, but those results did not reach statistical significance (0% vs 27%, P = 0.063). Hand-assisted @entity1104 was associated with higher @entity190 and length of stay as compared to robotic staging of endometrioid @entity1204 ( @entity1104 ). Minor wound complications were also more common (27% vs 2%, P = 0.012). CONCLUSIONS: Hand-assisted @entity1104 allows for thorough visual and tactile assessment of peritoneal surfaces. It represents a safe alternative to laparotomy for @entity43 with high risk of peritoneal spread. Long-term follow-up study is needed to determine oncologic adequacy of @entity1104 .
