Comparison of laparoscopy and laparotomy for management of endometrial carcinoma: a prospective randomized study with 11-year experience.
OBJECTIVE
We compared laparoscopic approach with the conventional laparotomy approach for the treatment of patients with endometrial carcinoma in developing country.


METHODS
Two hundred and seventy-two patients with endometrial carcinoma were enrolled in a prospective randomized trial and treated with laparoscopic or laparotomy approach.


RESULTS
One hundred and fifty-one patients were treated by laparoscopy, while one hundred and twenty-one patients were treated by laparotomy. The median operative time was 211 min in the laparoscopy group and 231 min in the laparotomy group (P > 0.05). The median blood loss was 86 ml in the laparoscopy group and 419 ml in the laparotomy group (P < 0.05). The median length of hospital stay was 3 days in the laparoscopy group and 6 days in the laparotomy group (P < 0.05). Pelvic lymphadenectomy was performed in all the patients. Para-aortic lymphadenectomy was performed in 15 % of the laparoscopy and 31.4 % of laparotomy group (P < 0.05). The overall survival and 5-year survival rate for the TLH were 94 and 96 % compared with 90.1 and 91 % in the TAH, respectively (P > 0.05).


CONCLUSIONS
Laparoscopic surgery is a safe and reliable alternative to laparotomy in the management of endometrial carcinoma patients, with significantly reduced hospital stay and postoperative complications; however, it does not seem to improve the overall survival and 5-year survival rate, although multicenter randomized trials are required to evaluate the overall oncologic outcomes of this procedure.
Department of Obstetrics and Gynecology, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Gongti South Road, No. 8, Chaoyang District, Beijing, 100020, China.
Qi
Q
Lu
Haiyan
H
Liu
Chongdong
C
Liu
Shuzhen
S
Wang
Shuhong
S
Li
Shuli
S
Guo
Junli
J
Lu
Zhenyu
Z
Zhang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011446:Prospective Studies