Comparison of reoperation rates, perioperative outcomes in women with endometrial cancer when the standard of care shifts from open surgery to laparoscopy.

Abstract

PURPOSE:

To analyze reoperation rates and perioperative outcomes after long-term follow-up of two surgical approaches in the treatment of endometrial cancer when the standard of care shifts from open surgery to laparoscopy at a university hospital.

METHODS:

In this retrospective monocenter study a total of 267 patients with endometrial cancer were included; 107 women underwent laparoscopy and 160 laparotomy. All of the patients received total hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy, depending on individual pathological features (e.g. high risk for positive lymph nodes) and the expertise of the surgeon.

RESULTS:

Repeat surgery was needed significantly more often in the laparotomy group in comparison with the laparoscopy group (11.9 vs. 0.9 %, respectively; P < 0.001). Hospital stays were longer in the laparotomy group in comparison with laparoscopy (16.2 vs. 9.5 days; P < 0.000001). Postoperative complications were significantly more frequent in the laparotomy group in comparison with laparoscopy (25.0 vs. 10.3 %; P < 0.01). Operating times and preoperative and postoperative hemoglobin differences were similar in the two groups (193.9 vs. 190.6 min, 2.0 vs. 1.8 g/dl). Intraoperative complication rates were similar in the two groups (3.8 vs. 5.6 %).

CONCLUSIONS:

Laparoscopy is a safe alternative to laparotomy for low risk endometrial cancer patients and offers markedly improved perioperative outcomes with a lower reoperation rate and fewer postoperative complications when the standard of care shifts from open surgery to laparoscopy in a university hospital.

• Authors: Alexander Boosz, Lothar Haeberle, Stefan P Renner, Falk C Thiel, Grit Mehlhorn, Matthias W Beckmann, Andreas Mueller
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 290 Issue 6 Pg. 1215-20 (Dec 2014) ISSN: 1432-0711 [Electronic] Germany
• PMID: 25009071 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Aged, 80 and over
• Animals
• Endometrial Neoplasms (pathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Hysterectomy
• Laparoscopy (methods)
• Laparotomy (adverse effects)
• Length of Stay
• Lymph Node Excision
• Middle Aged
• Neoplasm Staging
• Outcome Assessment, Health Care
• Ovariectomy
• Perioperative Period
• Postoperative Complications (etiology)
• Reoperation (statistics & numerical data)
• Retrospective Studies
• Second-Look Surgery
• Standard of Care