title: Total laparoscopic hysterectomy in the management of endometrial carcinoma.
abstract: 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.
authors.affiliation: Western Gynaecologic Cancert Centre, King Edward Memorial Hospital, Subiaco, Australia.
authors.forename: Tom P
authors.initials: TP
authors.lastname: Manolitsas
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: McCartney
mesh_terms: 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