{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:50:25Z","timestamp":1790509825803,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although robotics has been shown to improve outcomes in some high\u2010difficulty surgical category patients, it is unclear if such an approach may improve outcomes in elderly patients with endometrial carcinoma (EC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare robotic and laparotomic surgery in the treatment and staging of elderly EC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis was performed assessing the risk of overall, intra\u2010operative, and peri\u2010operative complications associated with the surgical approach (laparotomic vs robotic) for elderly patients with EC by relative risk (RR). Pooled means\u00a0\u00b1\u00a0standard deviation of length of stay were compared with the unpaired <jats:italic>t<\/jats:italic> test. Subgroup analyses for overall complications were performed based on different age cut\u2010offs (&gt;70, &gt;65, and &gt;75\u00a0years) and severity of complications (minor and major). A value of <jats:italic>P<\/jats:italic> less than 0.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five studies with 7629 EC patients were included. Pooled RR for robotic compared with laparotomic surgery was 0.40 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) for overall, 0.46 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.18) for intra\u2010operative, and 0.43 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) for peri\u2010operative complications. Pooled difference between means\u00a0\u00b1\u00a0standard deviation of length of stay for robotic versus laparotomic surgery was \u22123.34 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). At subgroup analyses, pooled RR of overall complications for robotic surgery versus laparotomic surgery was 0.34 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) in the &gt;70\u00a0years, 0.51 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) in the &gt;65\u00a0years, 0.20 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.12) in the &gt;75\u00a0years groups. Pooled RR was 0.50 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.1) in the minor complications subgroup, and 0.42 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002) in the major complications subgroup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Robotics might be a viable alternative to the laparotomic approach for EC in elderly patients because it significantly decreases the risk of overall and peri\u2010operative complications (mainly major complications), and the length of stay when compared with laparotomy. The decrease in risk of overall complications is greater with increasing patient age.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13766","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T15:54:43Z","timestamp":1622130883000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Laparotomic versus robotic surgery in elderly patients with endometrial cancer: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"157","author":[{"given":"Antonio","family":"Raffone","sequence":"first","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II  Naples Italy"},{"name":"Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero\u2010Univeristaria di Bologna University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Travaglino","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero\u2010Univeristaria di Bologna University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominga","family":"Boccia","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martino","family":"Vetrella","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Verrazzo","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Granata","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Casadio","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero\u2010Univeristaria di Bologna University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Insabato","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mollo","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit Department of Medicine, Surgery and Dentistry \"Schola Medica Salernitana\" University of Salerno  Baronissi Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Seracchioli","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero\u2010Univeristaria di Bologna University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21254"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.08.019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-019-00784-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.01.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13847"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05531-4"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05542-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6748a1"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_175666"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bulcan.2017.06.017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31961"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00130404-200511000-00002"},{"key":"e_1_2_8_14_1","volume-title":"SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988\u20132001, Patient and Tumor Characteristics","author":"Ries LAG","year":"2007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bulcan.2017.10.006"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0006"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.02.067"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574887110666150923115228"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2019.62.3.149"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.05.027"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.05.004"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13789"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003403"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046\u20104053\u20104\u20101"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.03.572"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000822"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.085"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4428-0"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.10.022"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-020-00811-5"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05299-2"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-019-00727-9"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqz132"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-017-0700-6"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23988"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-2092(06)60191-9"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2018.08.021"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2012.04.001"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ee6e4d"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000244"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.03.012"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000001073"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.04.014"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.07.010"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02038.x"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2016.05.013"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806395"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13766","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.13766","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13766","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T09:40:07Z","timestamp":1692956407000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.13766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,19]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/ijgo.13766"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.13766","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,19]]},"assertion":[{"value":"2021-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}