OBJECTIVE: To compare the demographics, cancer characteristics, and hospital outcomes of endometrial cancer patients undergoing a laparoscopically assisted vaginal hysterectomy (LAVH) versus a total abdominal hysterectomy (TAH). METHODS: Two California population databases (Office of Statewide Health Planning and Development and the California Cancer Registry) were linked using patient identifiers. Patients who underwent endometrial cancer surgery from 1997 to 2001 were identified. The combined database was queried for type of surgery, patient demographics, hospital outcomes, comorbidities, and cancer characteristics. Statistical analyses included the t test, chi2 test, and logistic regression. RESULTS: In this study, 978 endometrial cancer patients (7.7%) had an LAVH and 11,765 (92.3%) had a TAH. The mean ages for the 2 groups were 63.3 and 64.8 years, respectively. Lymphadenectomy was performed more frequently in LAVH patients compared with TAH patients (45.6 vs 41.1%; P = 0.006). Patients undergoing LAVH were more likely to be younger and healthier and have stage I or grade 1 disease (P < 0.0001). Total abdominal hysterectomy patients were more likely to have significant medical comorbidities. Mean length of stay for LAVH was 2.40 versus 4.36 days for TAH (P < 0.001), but mean hospital charges were comparable. Perioperative complications such as vascular and bowel injuries, pulmonary embolism, wound problems, and transfusions were significantly more common in TAH patients. CONCLUSION: Surgeons seem to carefully select endometrial cancer patients for laparoscopic surgery. Although surgical staging was performed in less than 50% of endometrial cancer patients, the rate was not worse in laparoscopic procedures. Short-term hospital complications were less common in the laparoscopy group.
OBJECTIVE: To compare the demographics, cancer characteristics, and hospital outcomes of endometrial cancerpatients undergoing a laparoscopically assisted vaginal hysterectomy (LAVH) versus a total abdominal hysterectomy (TAH). METHODS: Two California population databases (Office of Statewide Health Planning and Development and the California Cancer Registry) were linked using patient identifiers. Patients who underwent endometrial cancer surgery from 1997 to 2001 were identified. The combined database was queried for type of surgery, patient demographics, hospital outcomes, comorbidities, and cancer characteristics. Statistical analyses included the t test, chi2 test, and logistic regression. RESULTS: In this study, 978 endometrial cancerpatients (7.7%) had an LAVH and 11,765 (92.3%) had a TAH. The mean ages for the 2 groups were 63.3 and 64.8 years, respectively. Lymphadenectomy was performed more frequently in LAVHpatients compared with TAHpatients (45.6 vs 41.1%; P = 0.006). Patients undergoing LAVH were more likely to be younger and healthier and have stage I or grade 1 disease (P < 0.0001). Total abdominal hysterectomy patients were more likely to have significant medical comorbidities. Mean length of stay for LAVH was 2.40 versus 4.36 days for TAH (P < 0.001), but mean hospital charges were comparable. Perioperative complications such as vascular and bowel injuries, pulmonary embolism, wound problems, and transfusions were significantly more common in TAHpatients. CONCLUSION: Surgeons seem to carefully select endometrial cancerpatients for laparoscopic surgery. Although surgical staging was performed in less than 50% of endometrial cancerpatients, the rate was not worse in laparoscopic procedures. Short-term hospital complications were less common in the laparoscopy group.
Authors: N M Spirtos; J B Schlaerth; T W Spirtos; A C Schlaerth; P D Indman; R E Kimball Journal: Am J Obstet Gynecol Date: 1995-07 Impact factor: 8.661
Authors: James C Pavelka; Inbar Ben-Shachar; Jeffrey M Fowler; Nilsa C Ramirez; Larry J Copeland; Lynne A Eaton; Tom P Manolitsas; David E Cohn Journal: Gynecol Oncol Date: 2004-12 Impact factor: 5.482
Authors: Dennis R Scribner; Joan L Walker; Gary A Johnson; D Scott McMeekin; Michael A Gold; Robert S Mannel Journal: Gynecol Oncol Date: 2002-03 Impact factor: 5.482