Z Holub1, J Voracek, A Shomani. 1. Department of Obstetrics and Gynaecology, Baby Friendly Hospital, Kladno, Czech Republic.
Abstract
BACKGROUND: Laparoscopic hysterectomy and lymph node dissection have lately been reported as an alternative to an abdominal open procedure for the treatment of malignant gynaecological conditions. The laparoscopic operative technique has been evaluated and compared as to whether it is a safe, feasible and effective procedure. SUBJECTS: The study includes 78 women with indications for surgery for endometrial cancer stage I. A retrospective comparative study was undertaken at Baby Friendly Hospital, Kladno, in which 11 patients treated laparoscopically were compared with 26 patients treated by the open procedure of lymphadenectomy. We evaluated differences in the peri-and postoperative outcomes. RESULTS: All 11 procedures were successfully completed. The mean operating time was 153 min, and mean blood loss was 130 ml. The median hospital stay was 4.7 days. There were no major complications. CONCLUSIONS: Laparoscopic hysterectomy and lymphadenectomy seem to be the procedures which result in a shorter hospital stay and rapid recovery. This approach could potentially decrease morbidity historically associated with hysterectomy and lymphadenectomy performed abdominally. Only prospective randomised studies will be able to demonstrate the ability of operative laparoscopy to improve contemporary management of endometrial cancer.
BACKGROUND: Laparoscopic hysterectomy and lymph node dissection have lately been reported as an alternative to an abdominal open procedure for the treatment of malignant gynaecological conditions. The laparoscopic operative technique has been evaluated and compared as to whether it is a safe, feasible and effective procedure. SUBJECTS: The study includes 78 women with indications for surgery for endometrial cancer stage I. A retrospective comparative study was undertaken at Baby Friendly Hospital, Kladno, in which 11 patients treated laparoscopically were compared with 26 patients treated by the open procedure of lymphadenectomy. We evaluated differences in the peri-and postoperative outcomes. RESULTS: All 11 procedures were successfully completed. The mean operating time was 153 min, and mean blood loss was 130 ml. The median hospital stay was 4.7 days. There were no major complications. CONCLUSIONS: Laparoscopic hysterectomy and lymphadenectomy seem to be the procedures which result in a shorter hospital stay and rapid recovery. This approach could potentially decrease morbidity historically associated with hysterectomy and lymphadenectomy performed abdominally. Only prospective randomised studies will be able to demonstrate the ability of operative laparoscopy to improve contemporary management of endometrial cancer.
Authors: Gary S Leiserowitz; Guibo Xing; Arti Parikh-Patel; Rosemary Cress; Alireza Abidi; Anne O Rodriguez; John L Dalrymple Journal: Int J Gynecol Cancer Date: 2009-11 Impact factor: 3.437