Laparoscopic versus laparotomy approach to endometrial cancer: A prospective study

López-De la Manzanara Carlos, Martín-Francisco Cástor, Luengo-Tabernero Ángel, Garrido-Esteban Rosa Ana, León-Martín Alberto, Haya-Palazuelos Javier

Department of Obstetrics & Gynecology, Ciudad Real University General Hospital, Ciudad Real, Spain.
Research Department, Ciudad Real University General Hospital, Ciudad Real, Spain.

DOI: 10.4236/ojog.2013.34077                

Abstract

Objective: The aim of this study was to compare laparoscopic (LPS) and laparotomy (LPT) approaches for endometrial cancer, and to assess intraoperative and postoperative results, disease-free survival and overall survival. Methods: We designed a prospective observational study, every patient diagnosed of endometrial cancer and subsidiary to surgical staging was included. Total hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy were performed in every case. Paraaortic lymphadenectomy was performed depending on tumor histology. Results: 70 patients with endometrial cancer were enrolled, 49 (70%) were treated laparoscopically and 21 (30%) laparotomically. There was not statistical significant difference in the mean operative time, it was 183.06 ± 21.03 min (range 120 - 230) in the LPS group and 195.24 ± 28.39 min (range 130 - 240) in the LPT group, mean difference 12.16 (95% CI ﹣0.2 - 24). There was no difference in the number of lymph nodes resected. Mean blood loss was lower in the LPS group. There were less postoperative complications, 3 (6.12%) in the LPS group and 7 (33.3%) in the LPT group (p < 0.01). Mean hospital stay was significantly shorter in the LPS group 4.29 ± 1.62 days vs 8.81 ± 3.37 days in the LPT group (p < 0.01), mean difference 4.52 (95% CI 3.3 - 5.7). Overall survival was similar in both groups. Conclusion: Laparoscopic approach for endometrial cancer offers similar results in terms of survival and oncological radicality as the laparotomic approach and a lower rate of complications, a quicker convalescence time and a shorter hospital stay.

Keywords

Endometrial Cancer; Laparoscopy; Laparotomy; Minimally Invasive Surgery; Survival

Conflicts of Interest

The authors declare no conflicts of interest.

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