Laparoscopy versus laparotomy for the surgical management of apparent early stage ovarian cancer.
OBJECTIVE
To compare the results of laparoscopic staging of apparent early ovarian cancer (EOC) with those obtained with comprehensive surgical staging via laparotomy.


METHODS
Consecutive patients undergoing comprehensive laparoscopic staging for presumed EOC (LPS group; N=15) were compared with historical controls selected from consecutive women who have had conventional staging with open surgery (LPT group; N=19).


RESULTS
No difference was found in demographics and preoperative variables between the two groups. There were no significant differences between the two groups with regard to median number of lymph nodes and likelihood of identifying metastatic disease. No conversion to laparotomy and no intraoperative complication occurred in the LPS group. Operative time was significantly longer in the LPS group when compared with the LPT group (377+/-47 vs. 272+/-81 min, P=0.002). One patient in the LPS group had a retroperitoneal haematoma recognized in the postoperative period, and this required laparotomy and ligature of the hypogastric arteries to achieve haemostasis. Minor postoperative complications occurred in 1 (6.7%) patient in the LPS group and in 8 (42.1%) patients in the LPT group (P=0.047). Hospital stay was significantly shorter in the LPS group [3 (2-12) vs. 7 (4-14) days, P=0.001]. Median (range) follow-up time was 16 (4-33) and 60 (32-108) months in the LPS and LPT group, respectively. Eleven (73.3%) patients in the LPS group and 13 (68.4%) in the LPT group received adjuvant treatment. There were no recurrences in the LPS group whereas 4 (7.1%) recurrences occurred in the LPT group. Overall survival was 100% in both groups.


CONCLUSIONS
Our results suggest that laparoscopic comprehensive surgical staging of EOC is as safe and adequate as the standard surgical staging performed via laparotomy.
Ghezzi
Fabio
F
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Piazza Biroldi 1, 21100 Varese, Italy. fabio.ghezzi@uninsubria.it
Cromi
Antonella
A
Uccella
Stefano
S
Bergamini
Valentino
V
Tomera
Silvia
S
Franchi
Massimo
M
Bolis
Pierfrancesco
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome