Laparoscopic hysterectomy in the treatment of endometrial cancer: a systematic review.
We sought to compare the safety and efficacy of laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy and open surgery in women with endometrial cancer. A systematic review of the literature was undertaken. Bibliographic searches of the Health Technology Assessment, National Health Service Economic Evaluation, DARE, Cochrane Database of Systematic Reviews, MEDLINE, Embase, Pascal Biomed, and Cinahl databases were made. This study sought to include systematic reviews, health technology assessment reports, and randomized clinical trials comparing laparoscopic surgery (LS) with open surgery for the treatment of endometrial cancer. The quality of the included studies was assessed using a clinical trial checklist. The clinical studies finally included were 4 randomized clinical trials. The short-term results described show that LS offers advantages with respect to postoperative recovery, including reduced bleeding, a need for fewer days of intravenous fluid therapy, and a reduced need for pain killers. In addition, intraoperative and postoperative complications were fewer among those who underwent LS in all the studies consulted. The mean hospital stay of those who underwent LS was 3 to 4 days shorter, and they returned to normal activity sooner. The number of lymph glands resected was the same with both techniques. The LS was associated with a better quality of life after surgery. With respect to long-term results, no significant differences were found in relation to overall, disease-free or cause-specific survival, according to 1 study. The short-term results of LS are equivalent or better than those achieved with open surgery, whereas the long-term results obtained by both seems equivalent but more studies are needed assessing this outcome.
de la Orden
Susana Granado
SG
Health Technology Assessment Unit (UETS), Laín Entralgo Agency, Madrid, Spain.
Reza
M Mercedes
MM
Blasco
Juan A
JA
Andradas
Elena
E
Callejo
Daniel
D
Pérez
Tirso
T
D016889:Endometrial Neoplasms / Q000401:mortality* / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D010052:Ovariectomy; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome