Laparoscopic treatment of endometrial cancer: feasibility and results.
OBJECTIVE
The aim of this study was to compare laparoscopic and abdominal approach in the treatment of endometrial cancer in our department.


METHODS
From January 1999 to November 2002, 77 patients underwent surgery for stages I-III endometrial cancer. The first group of 36 patients had abdominal hysterectomy as well as salpingo-oophorectomy, with or without lymphadenectomy. The remaining 41 patients received laparoscopic assisted vaginal hysterectomy as well as salpingo-oophorectomy, with or without lymphadenectomy. In this retrospective study, we have compared the surgical results, the short- and long-term morbidity and the outcome of the two patient groups.


RESULTS
Body mass index (BMI) was significantly higher in the laparoscopic group (27.3 versus 24.6; p=0.009). The average time for surgery was significantly longer for the laparoscopic group (143.6 min versus 109.7 min; p=0.0001), but lymphadenectomy was performed in more patients (63.4% versus 25%; p=0.001). Postoperative hospital stay was significantly longer in patients undergoing the abdominal approach (4.59 days versus 3.18 days; p<0.0001). No blood transfusions were performed and the rates of complications were similar in the two groups. No differences were found in recurrence and survival rate.


CONCLUSIONS
In our experience, laparoscopic and abdominal surgery can achieve similar results in the treatment of endometrial cancer. In our series, even with the BMI and the number of lymphadenectomies being higher in the laparoscopic group, the rates of complications were similar in the two groups.
Volpi
Eugenio
E
Department of Gynecologic Oncology, University of Turin, Mauriziano Umberto I Hospital, Turin and Institute for Cancer Research and Treatment Candiolo, Italy.
Ferrero
Annamaria
A
Jacomuzzi
Maria Elena
ME
Carus
Alice Peroglio
AP
Fuso
Luca
L
Martra
Francesca
F
Sismondi
Piero
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D016889:Endometrial Neoplasms / Q000145:classification / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome