title: Two-port access laparoscopic surgery in gynecologic oncology.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the feasibility and safety of 2-port access (TPA) laparoscopy in gynecologic oncology.
  
  
  METHODS
  This was a retrospective review of 81 consecutive patients who underwent TPA laparoscopic surgery for various gynecologic cancers from March 2009 to September 2011. The TPA system consisted of a single multichannel port at the umbilicus and an ancillary 5-mm port in the suprapubic area.
  
  
  RESULTS
  The surgical procedures included comprehensive ovarian cancer staging (33 patients), radical hysterectomy with pelvic lymph node dissection (19 patients), and endometrial cancer staging (29 patients). All surgical procedures were completed laparoscopically with no conversion to laparotomy. Two cases required 1 or 2 additional ports. The mean operating time, estimated blood loss, and number of lymph nodes were 253.8 minutes, 170.7 mL, and 34.9, respectively. Three patients (9.1%) with ovarian cancer and 4 patients (13.8%) with endometrial cancer were upstaged after surgery. The mean postoperative hospital stay was 6.6 days, and the mean postoperative pain scores (0-10 scale) were 3.4 at 6 hours, 3.0 at 24 hours, and 2.5 at 48 hours. Postoperative complications occurred at a low incidence (4.9%) and included one umbilical hernia, one vault dehiscence, and one lumbosacral nerve injury.
  
  
  CONCLUSIONS
  Two-port access laparoscopic surgery using a single multichannel port system is a feasible and safe procedure in selected patients with gynecologic cancers. Prospective randomized trials will permit the evaluation of the potential benefits of this minimally invasive surgical technique.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea.
authors.forename: Maria
authors.initials: M
authors.lastname: Lee
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Sang Wun
authors.initials: SW
authors.lastname: Kim
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000401:mortality*; D010535:Laparoscopy / Q000295:instrumentation / Q000401:mortality*; D007813:Laparotomy / Q000401:mortality*; D008197:Lymph Node Excision / Q000401:mortality*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate