Minilaparotomy in early stage endometrial cancer: an alternative to standard and laparoscopic treatment.
OBJECTIVE
Our objective was to determine whether minilaparotomy could be a safe and feasible approach for the surgical treatment of early endometrial cancer patients and whether it could be considered a valid alternative to the laparoscopic treatment.


METHODS
A pilot study of 50 consecutive patients with FIGO stage I-IV endometrial cancer undergoing surgery at our Department was performed between May and December 2001. All patients were evaluated for a minimal transabdominal approach. Exclusion criteria were considered: special histotype, poorly differentiated tumors, clinical stage >/=Ic, Ca125 >35 U/ml, BMI >30, lymph nodal involvement assessed by MRI, and severe cardiopulmonary disease precluding steep Trendelenburg position.


RESULTS
Twenty-six (52%) cases were considered eligible for minilaparotomy. The mean age was 55.4 years and the mean BMI was 24.1. All patients underwent TAH, BSO, pelvic lymphadenectomy +/- omental or peritoneal biopsy. A mean number of 28 pelvic lymph nodes were removed. The mean operative time was 113.0 min and the mean intraoperative blood loss was 220.0 ml. There was 1 severe operative hemorrhage and 1 patient needed postoperative blood transfusion. No immediate complications of wound infection or separation occurred. The mean hospital stay was 3.4 days. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy, showing substantially comparable results.


CONCLUSIONS
Minilaparotomy is a feasible alternative to the standard treatment in endometrial cancer patients. It offers the patient a cost-effective procedure that avoids many of the potential complications of standard therapy, prevents long hospital recovery periods, and accomplishes all of the important goals of standard recommendations.
Fagotti
Anna
A
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Ferrandina
Gabriella
G
Longo
Romina
R
Mancuso
Salvatore
S
Scambia
Giovanni
G
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome