Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer.
OBJECTIVE
To compare feasibility, accuracy, and safety of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer.


METHODS
Outcomes of patients with stage I ovarian and fallopian tubal cancer who underwent complete surgical staging at Asan Medical Center, Korea between 2004 and 2007 were retrospectively evaluated.


RESULTS
Nineteen patients were surgically staged through laparoscopy and 33 through laparotomy. There were no between-group differences in mean age, parity, body mass index, lymph nodes retrieved, or omentum specimen size, nor were there between-group differences in the percentage of patients who were postmenopausal, those referred for restaging, in the time interval to restaging, in those upstaged after surgery, or in those with intraoperative tumor rupture. The laparoscopy group had significantly shorter operating time (221 +/- 83 min versus 275 +/- 63 min, P = 0.012), less blood loss (240 +/- 228 mL versus 568 +/- 451 mL, P = 0.005), less transfusion requirement (5.3% versus 30.3%, P = 0.033), faster return of bowel movement (1.3 +/- 0.7 days versus 3.6 +/- 1.7 days. P < 0.001), and shorter postoperative hospital stay (8.9 +/- 6.1 days versus 14.5 +/- 5.6 days, P = 0.002) and time interval to adjuvant chemotherapy (12.8 +/- 4.9 days versus 17.6 +/- 8.3 days, P = 0.049). There were no postoperative complications requiring further management. After a median follow-up time of 17 months (range 1-44 months), there was no recurrence or death from disease in either group.


CONCLUSIONS
Laparotomy and laparoscopy showed similar surgical staging adequacy and accuracy, and laparoscopy showed more favorable operative outcomes. Laparoscopy was safe for early-stage ovarian and fallopian tubal cancer, although follow-up time was relatively short.
Park
Jeong-Yeol
JY
Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
Kim
Dae-Yeon
DY
Suh
Dae-Shik
DS
Kim
Jong-Hyeok
JH
Kim
Yong-Man
YM
Kim
Young-Tak
YT
Nam
Joo-Hyun
JH
D000328:Adult; D005185:Fallopian Tube Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity