title: Comparison of laparoscopy and laparotomy for endometrial cancer.
abstract: OBJECTIVE
  To compare the safety and efficacy of laparoscopy and laparotomy on clinical outcomes among patients with endometrial cancer.
  
  
  METHODS
  Eligible randomized controlled trials (RCTs) conducted between 1966 and June 2010 were analyzed by meta-analysis.
  
  
  RESULTS
  Eight RCTs were included, with 3599 patients in total. No significant difference was observed between laparoscopy and laparotomy in overall (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.50-1.82; P=0.892), disease-free (OR, 0.96; 95% CI, 0.50-1.82; P=0.892), or cancer-related (OR, 0.90; 95% CI, 0.27-3.08; P=0.871) survival. More intraoperative complications (OR, 1.33; 95% CI, 1.03-1.73; P=0.030), fewer postoperative complications (OR, 0.59; 95% CI, 0.46-0.75; P<0.001), longer operative time (standardized mean difference [SMD], 0.80; 95% CI, 0.46-1.15; P<0.001), lower blood loss (SMD, -2.29; 95% CI, -3.67 to -0.91; P=0.001), and shorter hospital stay (SMD, -2.60; 95% CI, -3.47 to -1.72; P<0.001) were associated with laparoscopy. There was no significant difference between the groups in pelvic (SMD, 0.22; 95% CI, -0.03 to 0.48; P=0.086) or para-aortic (SMD, 0.54; 95% CI, -0.04 to 1.11; P=0.067) lymph node yield.
  
  
  CONCLUSIONS
  Laparoscopy has short-term advantages and seemingly equivalent long-term outcomes and, in experienced hands, might be a feasible alternative to laparotomy for endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Cui
authors.forename: Lin
authors.initials: L
authors.lastname: Jia
authors.forename: Shuhui
authors.initials: S
authors.lastname: Hong
authors.forename: Beihua
authors.initials: B
authors.lastname: Kong
authors.forename: Dadong
authors.initials: D
authors.lastname: Li
mesh_terms: D016889:Endometrial Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome