Laparoendoscopic Single-site Surgery (LESS) for Prophylactic Salpingo-oophorectomy Improves Cosmetic Satisfaction Compared to Standard Laparoscopy.
OBJECTIVE
Less invasive prophylactic bilateral salpingo-oophorectomy (PBSO) may diminish the general consequences of surgery for BRCA mutation carriers. The objective of the present study was to compare the psychological impact and satisfaction following minimal-invasive laparoendoscopic single-site surgery (LESS) versus that observed with the standard procedure.


METHODS
This prospective longitudinal study was proposed to all consecutive patients who underwent ambulatory PBSO between January 2012 and January 2014 at our Center. The psychological impact and esthetic satisfaction were prospectively studied. Patients rated their satisfaction using the 4-grade Likert scale. Their emotional state and postoperative pain were explored respectively with validated questionnaires (IES-R, PANAS) and the Verbal Numerical Rating Scale (VNRS). Operative outcomes were also analyzed.


RESULTS
Twenty patients underwent LESS PBSO and 10 patients had the standard laparoscopic (SL) PBSO. The mean satisfaction scores were significantly higher in the LESS group one month and six months after surgery. Both groups reported a reduction of intrusive thoughts and negative affects after surgery. Postoperative pain and operative outcomes were similar.


CONCLUSIONS
A significant improvement of cosmetic satisfaction after LESS compared to SL could help patients accept PBSO. The emotional impact of PBSO is not modified by ambulatory LESS.
Department of Surgery, Institut Gustave Roussy, Villejuif, France.
Gregoire
G
Miailhe
Department of Supportive Care, Institut Gustave Roussy, Villejuif, France.
Sarah
S
Dauchy
Department of Surgery, Institut Gustave Roussy, Villejuif, France.
Enrica
E
Bentivegna
Department of Surgery, Institut Gustave Roussy, Villejuif, France.
Sebastien
S
Gouy
Department of Supportive Care, Institut Gustave Roussy, Villejuif, France «Psychopathologie et Processus de Santé» laboratory - EA 4057, Psychology Institute, Paris Descartes - Sorbonne Paris Cité University, Boulogne, France.
Cecile
C
Charles
Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
Suzette
S
Delaloge
Department of Surgery, Institut Gustave Roussy, Villejuif, France.
Philippe
P
Morice
Department of Surgery, Institut Gustave Roussy, Villejuif, France catherine.uzan@gmail.com.
Catherine
C
Uzan
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D054023:Lasers, Semiconductor; D008137:Longitudinal Studies; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000639:trends*; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D058994:Salpingectomy / Q000639:trends*
BRCA mutation; Laparoendoscopic single-site surgery; ambulatory surgery; cosmetic satisfaction; prophylactic bilateral salpingo-oophorectomy