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Liu Y, Mao M, Bai J, Cai M, Wang Q, Fu H, Zhao M, Wang C, Si L, Guo R. Is robotic-assisted vaginectomy a better choice in vaginal high-grade squamous intraepithelial lesions than conventional laparoscopic surgery? BMC Womens Health 2024; 24:36. [PMID: 38218831 PMCID: PMC10788024 DOI: 10.1186/s12905-024-02882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Vaginectomy has been shown to be effective for select patients with vaginal high-grade squamous intraepithelial lesions (HSIL) and is favored by gynecologists, while there are few reports on the robotic-assisted laparoscopic vaginectomy (RALV). The aim of this study was to evaluate the safety and treatment outcomes between RALV and the conventional laparoscopic vaginectomy (CLV) for patients with vaginal HSIL. METHODS This retrospective cohort study was conducted in 109 patients with vaginal HSIL who underwent either RALV (RALV group) or CLV (CLV group) from December 2013 to May 2022. The operative data, homogeneous HPV infection regression rate and vaginal HSIL regression rate were compared between the two groups. Student's t-test, the Mann-Whitney U test, Pearson χ2 test or the Fisher exact test, Kaplan-Meier survival analysis and Cox proportional-hazards models were used for data analysis. RESULTS There were 32 patients in the RALV group and 77 patients in the CLV group. Compared with the CLV group, patients in the RALV group demonstrated less estimated blood loss (41.6 ± 40.3 mL vs. 68.1 ± 56.4 mL, P = 0.017), lower intraoperative complications rate (6.3% vs. 24.7%, P = 0.026), and shorter flatus passing time (2.0 (1.0-2.0) vs. 2.0 (2.0-2.0), P < 0.001), postoperative catheterization time (2.0 (2.0-3.0) vs. 4.0 (2.0-6.0), P = 0.001) and postoperative hospitalization time (4.0 (4.0-5.0) vs. 5.0 (4.0-6.0), P = 0.020). In addition, the treatment outcomes showed that both RALV group and CLV group had high homogeneous HPV infection regression rate (90.0% vs. 92.0%, P > 0.999) and vaginal HSIL regression rate (96.7% vs. 94.7%, P = 0.805) after vaginectomy. However, the RALV group had significantly higher hospital costs than that in the CLV group (53035.1 ± 9539.0 yuan vs. 32706.8 ± 6659.2 yuan, P < 0.001). CONCLUSIONS Both RALV and CLV can achieve satisfactory treatment outcomes, while RALV has the advantages of less intraoperative blood loss, fewer intraoperative complications rate and faster postoperative recovery. Robotic-assisted surgery has the potential to become a better choice for vaginectomy in patients with vaginal HSIL without regard to the burden of hospital costs.
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Affiliation(s)
- Yana Liu
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Meng Mao
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Jing Bai
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Mingbo Cai
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Qian Wang
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Hanlin Fu
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Mengling Zhao
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Chunfang Wang
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Lulu Si
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China
| | - Ruixia Guo
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou City, 450052, Henan, China.
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