[Comparison of different approaches in surgical management of early endometrial cancer].
The objective is to assess the feasibility of laparoscopy in the treatment of endometrial carcinoma and to compare operating data and morbidity to laparotomy. Retrospective review of 70 consecutive patients with supposed early endometrial cancer managed between December 2000 and December 2005. Two groups were defined, whether they had been operated by laparoscopy (N = 44 ; LPS group) or by laparotomy (N = 21 ; LPM group). Both groups were comparable in mean age and body mass index. There was no significant difference in median operating time for LPS group (240 minutes [90-390]) and LPM group (195 minutes [120-600]), (p = 0.234). Intraoperative complications occurred in 2 LPS patients (4.7 %) and in 2 LPM cases (9.5 %). Women who underwent laparoscopy had more pelvic lymph nodes removed (11.5 [2-33] versus 7.5 [3-37], p < 0.05). There were comparable early and late postoperative complications in patients managed by laparoscopy (5 and 0 cases ; 27.8 and 0 %) and by laparotomy (5 and 2 cases ; 11.6 and 4.5 %), (p = 0.143 and p > 0.999). Hospital stay was longer in LPM group (9.5 days [6-39] versus 5.0 (4-27), p < 0.05). Patients who undergo laparoscopy have more pelvic lymph nodes removed, with comparable operating time, shorter hospital stay, and similar morbidity. Laparoscopic staging combined with vaginal hysterectomy appears to be a feasible alternative to conventional surgical approach in patients with endometrial carcinoma.
Service de chirurgie gynécologique, Hôpital européen Georges Pompidou, 20, rue Leblanc, 75015 Paris. bats@wanadoo.fr
Anne-Sophie
AS
Bats
Gilles
G
Chatellier
Denys
D
Clément
Florence
F
Larousserie
Marie-Aude
MA
Lefrère-Belda
Fabrice
F
Lecuru
Claude
C
Nos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors