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Laparoscopy Safe, Effective In Endometrial Cancer
A DGReview of :"Laparoscopic surgery for endometrial cancer: long-term results of a multicentric study."
European Journal of Gynaecological Oncology
09/17/2002
By Anne MacLennan
Laparoscopically assisted surgical staging of endometrial cancer is as safe as an open procedure, and may be considered for the endometrial malignancy that typically occurs in obese, older high-risk women.
These are among conclusions of a prospective multicentre study in the Czech Republic that found no difference in recurrence or survival between laparoscopic and open surgery in these patients.
The laparoscopic approach to endometrial cancer has gradually gained wider acceptance by doctors over laparotomy, the more traditional surgical treatment.
Dr Z Holub and colleagues from the Department of Obstetrics and Gynecology, Baby Friendly Hospital, Kladno, sought to report peri- and postoperative outcomes, as well as long-term results, of the technique.
The study was done at three oncolaparoscopic centres and included 221 women who had undergone laparoscopic (177 women) or abdominal (44) hysterectomy with bilateral salpingo-oophorectomy and lymphadenectomy.
Women with stage IA, grade one did not undergo lymphadenectomy unless they had a high-risk histologic tumor type. In 145 women with disease greater than IA or grades other than one, lymph node dissection was done.
Mean age and weight were similar in the women in both the laparoscopic and open surgery groups, and perioperative blood loss was comparable between groups.
Although the length of operating time for the laparoscopic surgery was significantly longer than for the laparotomy procedure (163.3 minutes versus 114.7 min), patients were discharged from hospital much earlier after the former (3.9 days; range two to 16) than the latter procedure (7.3 days; range five to 16).
Nor was there any significant difference between the two groups in surgical complications.
Long-term results were similar. There were no significant differences in tumour recurrence or recurrence-free survival after a median follow-up of 33.6 months for the laparoscopy and 45.2 months for the open group.
Eur J Gynaecol Oncol 2002;23(4):305-10
"Laparoscopic surgery for endometrial cancer: long-term results of a multicentric study."
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