Total laparoscopic hysterectomy in the management of endometrial carcinoma.
OBJECTIVE
To compare total laparoscopic hysterectomy (TLH) with open hysterectomy in the management of endometrial carcinoma.


METHODS
Retrospective chart review (Canadian Task Force classification II-3).


METHODS
Gynecologic cancer center.


METHODS
All women with endometrial carcinoma managed between January 1, 1993, and June 30, 1999.


METHODS
Of 403 patients reviewed, in 161 (40%) the surgical intention was laparoscopic management, in 230 (57%) the intention was open management, and in 12 (3%) it was vaginal hysterectomy. Total laparoscopic hysterectomy was successfully completed in 153 (95%) of the laparoscopic group.


RESULTS
Mean weight of women in the laparoscopic group (80.1 kg) was greater than that in the open group (73.3 kg, p = 0.002), and included 27 patients weighing over 100 kg (maximum individual weight 170 kg). Mean operating times were 138 minutes for laparoscopy and 121 minutes for the open procedure (p = 0.002). Complications differed, with significantly more occurring in the open group (43%, 100) than in the laparoscopic group (17%, 27, p <0.00001). Mean postoperative hospital stay was significantly shorter for the laparoscopic group (4.3 days) than for the open group (8.5 days, p = 0.0001). Conclusion. TLH combined with laparoscopic surgical staging has many advantages over the open approach, especially in obese women.
Manolitsas
Tom P
TP
Western Gynaecologic Cancert Centre, King Edward Memorial Hospital, Subiaco, Australia.
McCartney
Anthony J
AJ
D000368:Aged; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome