Boulay, Richard, MD

Hordendorf, Amy

Martino, Martin A, MD

Morcrette, Rachel, PA-C

Nguyen, Hai-Yen, MD

Patriarco, Jeremy

Shubella, Jocelyn

Thomas, M Bijoy, MD

Williams, Shamol, MSII

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Obstetrics & GynecologyBenchmarking Quality Metrics for EndometrialCancer Patients: Robotics vs. LaparoscopyMartin A. Martino MDLehigh Valley Health Network, martin_a.martino@lvhn.orgJocelyn ShubellaLehigh Valley Health Network, Jocelyn.Shubella@lvhn.orgShamol Williams MSIILehigh Valley Health Network, Shamol.Williams@lvhn.orgRachel Morcrette PA-CLehigh Valley Health Network, Rachel_M.Morcrette@lvhn.comJeremy PatriarcoUniversity of South Florida College of Medicine, Jeremy.Patriarco@lvhn.orgSee next page for additional authorsFollow this and additional works at: https://scholarlyworks.lvhn.org/obstetrics-gynecologyPart of the Obstetrics and Gynecology Commons, Oncology Commons, and the SurgeryCommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtMartino, M., Shubella, J., Williams, S., Morcrette, R., Patriarco, J., Nguyen, H., Hordendorf, A., Thomas, M., & Boulay, R. (2012,March 24-27). Benchmarking Quality Metrics for Endometrial Cancer Patients: Robotics vs. Laparoscopy. Poster presented at: The 2012Society of Gynecologic Oncology Annual Meeting, Austin, TX.AuthorsMartin A. Martino MD, Jocelyn Shubella, Shamol Williams MSII, Rachel Morcrette PA-C, Jeremy Patriarco,Hai-Yen Nguyen MD, Amy Hordendorf, M Bijoy Thomas MD, and Richard Boulay MDThis poster is available at LVHN Scholarly Works: https://scholarlyworks.lvhn.org/obstetrics-gynecology/31Lehigh Valley Health Network, Allentown, PA; 2University of South Florida College of Medicine, Tampa, FLThe aim of this study was to identify quality indicators following robotic surgery in patients with endometrial cancer. Primary outcome measures were length of stay (LOS), estimated blood loss (EBL), and operative times (OR times). Secondary outcome measures were transfusion rates and perioperative complication rates.Benchmarking Quality Metrics for Endometrial Cancer Patients:Robotics vs. LaparoscopyObjective:Table 1. Patient Demographics Robotic(n=207)Laparoscopic (n=134) p valueAGE (years)     Mean + SD 62.4 + 11.9 63.7 + 12.2 0.321BMI (kg/m2)    Mean + SD 35.8 + 9.0 33.9 + 8.8 0.121CANCER STAGE (n)    I 139 93      II 13 6    III 16 4    Not specified 39 31Methods:Three hundred forty-one patients (207 robotic and 134 laparoscopic) were analyzed. There were no significant differences between the two groups in age, BMI, or cancer stage. (Table 1) For the robotic cohort, the median pelvic, periaortic and total nodal counts were 12 (range: 1-34), 4 (range: 1-19), and 14 (range: 1-43). For the laparoscopic cohort, they were 12.5 (range: 2-22), 4 (range: 1-17), and 16 (range: 2-35), respectively. Five robotic cases (2.4%) and 10 Results:Patients with endometrial cancer who have robotic surgery experience shorter operative times, less blood loss, shorter length of stays, fewer transfusions and fewer complications compared to laparoscopic surgery.  These findings suggest surgical quality outcomes may be improved for patients who have robotic surgery for endometrial cancer.Conclusion:Martin A. Martino MD1; Jocelyn Shubella1; Shamol Williams2, Rachel Morcrette PA-C1, Jeremy Patriarco1, Hai-Yen Nguyen MD1, Amy Hordendorf1; M. Bijoy Thomas MD1; Richard Boulay MD1Table 2. Outcome Measures Robotic(n=207)Laparoscopic(n=134) p valuePELVIC LYMPH NODE RETRIEVAL        Median (Range) 12 (1-34) 12.5 (2-22)PERIAORTIC LYMPH NODE RETRIEVAL    Median (Range) 4 (1-19) 4 (1-17)TOTAL LYMPH NODE RETRIEVAL    Median (Range) 14 (1-43) 16 (2-35)CONVERSION TO LAPAROTOMY    N (%) 5 (2.4) 10 (7.5) .03TRANSFUSIONS    N (%) 1 (0.5) 12 (9.0) <.0001OPERATIVE TIME (min)    Median (Range) 161 (62-366) 180 (92-448) .01TOTAL OR TIME (min)    Median (Range) 229 (118-466) 253 (154-534) .03ESTIMATED BLOOD LOSS (mL)    Median (Range) 50 (10-1200) 150 (10-1600) <.001LENGTH OF STAY (d)    Median (Range) 1 (1-12) 1.5 (1-17) .002PERIOPERATIVE COMPLICATIONS    N (%) 19 (9.2%) 25 (18.7%) .01•  From 6/2008 to 6/2011, all consecutive patients diagnosed with endometrial cancer who were scheduled for a robotic-assisted hysterectomy by the gynecologic oncology service were prospectively captured. They were compared to a retrospective cohort of endometrial cancer patients who had a laparoscopic-assisted hysterectomy from 9/2005 to 6/2011. •  Demographic data included age, BMI, and cancer stage. •  Outcome measures reviewed were lymph node retrieval, LOS, EBL, OR times, transfusion rates and complications. •  SPSS was used to perform Student’s t-tests and Pearson’s chi-squared tests. •  This study was IRB-approved.laparoscopic cases (7.5%) were converted to laparotomies (P=.03). One robotic case (.48%) and 12 laparoscopic cases (8.96%) received transfusions (P<.0001). Median operative time (skin incision to closure) was 161 min (range: 62-366) for robotics and 180 min (range: 92-448) for laparoscopies (P=.01). Median OR room time was 229 min (range: 118-466) and 253 min (range: 154-534), respectively (P=.03). Median EBL was 50mL (range: 10-1200) for the robotic group and 150mL (range: 10-1600) for the laparoscopic group (P<.001). Median LOS was 1 day (range: 1-12) for robotics and 1.5 days (range: 1-17) for laparoscopies (P=.002). Nineteen robotics patients experienced a perioperative complication (9.2%) compared to 25 laparoscopic patients (18.7%) (P=.01). (Table 2)

Benchmarking Quality Metrics for Endometrial Cancer Patients: Robotics vs. Laparoscopy

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1002&context=obstetrics-gynecology

Benchmarking Quality Metrics for Endometrial Cancer Patients: Robotics vs. Laparoscopy

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