摘要
Objective. To assess the feasibility of laparoscopy in the treatment of early stage endometrial carcinoma and follow up outcomes compared to classic laparotomy. Methods. A retrospective review of 90 consecutive patients with endometrial cancer managed between January 1997 and December 2003. Two groups were defined whether they had been treated by laparoscopy (N = 38; LPS group) or by laparotomy (N = 37; LPM group). Nine patients treated by vaginal hysterectomy and 6 cases with stages III- IV were excluded from the study. Results. Both groups were comparable in mean age and mean BMI. Mean operating time was longer for LPS group, 164.9 ± 5.60 (77- 240) vs. 129.97 ± 5.08 (60- 180) min (P < 0.05). Intraoperative complications were seen in 7 patients (18.9% ) from LPM and in 5 cases (13.2% ) in the laparoscopic group. Two patients (5.2% ) initially evaluated by laparoscopy were converted into laparotomy due to an increasing and uncontrollable hypercapnia. There were more post-operative complications in patients managed by laparotomy (14 cases; 38.8% ), than by laparoscopy (7 cases; 18.4% ) (P < 0.05). Blood transfusion was necessary in 4 patients (10.8% ) in LPM group while none was required in LPS group (P < 0.01). Hospital readmission was only recorded in 3 patients treated by laparotomy (6.7% ) (P < 0.05). Hospital stay was longer in LPM group 7.06 ± 0.58 (4- 21) vs LPS 5.04 ± 0.73 (2- 17) days (P < 0.05). With a median follow up of 53.21 ± 4.32 months for LPM (5- 90) and 36.31 ± 2.75 months for LPS (9- 65) there was no significant difference in disease recurrence between the two groups. Conclusion. Laparoscopic staging combined with vaginal hysterectomy appears to be a feasible alternative to classical surgical approach in patients with early stage I or II endometrial carcinoma.
Objective. To assess the feasibility of laparoscopy in the treatment of early stage endometrial carcinoma and follow up outcomes compared to classic laparotomy. Methods. A retrospective review of 90 consecutive patients with endometrial cancer managed between January 1997 and December 2003. Two groups were defined whether they had been treated by laparoscopy (N = 38; LPS group) or by laparotomy (N = 37; LPM group). Nine patients treated by vaginal hysterectomy and 6 cases with stages III- IV were excluded from the study. Results. Both groups were comparable in mean age and mean BMI. Mean operating time was longer for LPS group, 164.9 ± 5.60 (77- 240) vs. 129.97 ± 5.08 (60- 180) min (P < 0.05). Intraoperative complications were seen in 7 patients (18.9% ) from LPM and in 5 cases (13.2% ) in the laparoscopic group. Two patients (5.2% ) initially evaluated by laparoscopy were converted into laparotomy due to an increasing and uncontrollable hypercapnia. There were more post-operative complications in patients managed by laparotomy (14 cases; 38.8% ), than by laparoscopy (7 cases; 18.4% ) (P < 0.05). Blood transfusion was necessary in 4 patients (10.8% ) in LPM group while none was required in LPS group (P < 0.01). Hospital readmission was only recorded in 3 patients treated by laparotomy (6.7% ) (P < 0.05). Hospital stay was longer in LPM group 7.06 ± 0.58 (4- 21) vs LPS 5.04 ± 0.73 (2- 17) days (P < 0.05). With a median follow up of 53.21 ± 4.32 months for LPM (5- 90) and 36.31 ± 2.75 months for LPS (9- 65) there was no significant difference in disease recurrence between the two groups. Conclusion. Laparoscopic staging combined with vaginal hysterectomy appears to be a feasible alternative to classical surgical approach in patients with early stage I or II endometrial carcinoma.
