[Advantages of laparoscopic assisted vaginal hysterectomy in surgery of endometrial carcinoma].
BACKGROUND
In to respect the principles of oncological surgery and to reduce the operative morbidity, the authors of this study propose to find the proper place of the laparoscopic-assisted vaginal hysterectomy in the surgery of endometrial carcinomas.


METHODS
Between the 1st of June 2002 and 31 of May 2005, we realize a retrospective and comparative study for 36 laparoscopic-assisted vaginal hysterectomy and 20 laparotomies concerning 56 patients.


RESULTS
In primary stages (stages I and II of FIGO), laparoscopic assisted vaginal hysterectomy is as powerful as the laparotomy whereas in more advanced stages, laparotomy was more complete and effective (p=0,07). One conversion case was observed (2.8%) in a context of peritoneal carcinosis (stage IIIc). There was not statistically significant difference about the operatives complications (p = 0.51). On the other hand, the postoperative comfort was so far better in the laparoscopic-assisted vaginal hysterectomy group (p=0.0002). The average delay of followed without relapses was 22,3 months in the laparoscopic-assisted vaginal hysterectomy group versus 23 months in the laparotomy group (p=0.51).


CONCLUSIONS
Considering these results, the authors retain that, in primary stages (I-II, FIGO), laparoscopic-assisted vaginal hysterectomy represents a real option in the surgery of endometrial carcinoma. On the other hand, the advanced stages should be reserved for laparotomy.
Guèye
S M K
SM
Clinique Gynécologique et Obstétricale du CHU A. Le Dantec de Dakar, 3, avenue Pasteur, BP 3001 Dakar. kaneg@sentoo.sn
Aissi
G
G
Youssef
C
C
Raiga
J
J
Arnouuld
N
N
Bellocq
J P
JP
Moreau
J C
JC
Brettes
J P
JP
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013997:Time Factors