Impact of Age on Surgical Outcomes after Robot Assisted Laparoscopic Hysterectomies

Abstract

Objective: To estimate the impact of patient’s age on surgical outcomes in patients undergoing robotic hysterectomy. Methods: A retrospective review of prospectively collected cohort data for a consecutive series of patients undergoing gynecologic robotic surgery. Patient’s age and perioperative variables were collected from the database, charts, and other hospital records of all patients undergoing robotic hysterectomy. Results: 399 patients underwent robotic surgery for gynecologic disease. 370 patients who were under age 70 were compared with 29 patients who were over age 70. When comparing all patients under age 70 with patients over age 70, the mean age was 48.4 and 77 (P < 0.05), mean BMI was 32.1 and 28.3 kg/m2 (P < 0.05), mean procedure time was 185 and 211 minutes (min) (P = 0.09), mean console time was 123 and 148 min (P = 0.056), mean OR (Operating room) time was 237 and 273, mean EBL (Estimated blood loss) was 71 and 65 ml (P = 0.74), Hb (Hemoglobin) drop was 1.4 and 1.2 (P = 0.45), uterine weight was 212 and 95 gm (P = 0.98), and length of stay was 1.4 and 1.6 days (P = 0.33) (Table 1). The patients over age 70, when procedures were combined, had a statistically significant lower mean BMI, uterine weight and longer Operating room (OR) time. However, when stratified by the type of procedure performed, there was no difference in surgery times among those under 70 and over 70 years of age. The elderly patients were more likely to have cancer, which was in almost half the elderly patients, and thus necessitate staging. Thus adding the performance of lymph node dissection likely resulted in the increased length of the surgery time that was noted in the combined group (Tables 1, 2). There were no operative deaths. Conclusions: Advanced age does not appear to be associated with an increased risk of morbidity, or adverse perioperative outcomes in patients undergoing robotic hysterectomy.