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Comparison of laparoscopy and laparotomy in patients with endometrial cancer
Anton Langebrekke1, Olav Istre, Anne Cecilie Hallqvist
1Department of Obstetrics and Gynecology, Ullevaal Hospital, University of Oslo, N-0407 Oslo, Norway.
Study Objective:
To evaluate results and feasibility of laparoscopic surgery in patients with stage I endometrial cancer.
Design:
Prospective, nonrandomized study (Canadian Task Force classification II-I).
Setting:
University tertiary referring center.
Patients:
Fifty-one women with stage I endometrial cancer followed for 1 year.
Intervention:
Laparoscopy (27 women) and open surgery (24).
Measurements And Main Results:
We recorded operating time, complications, and length of hospital stay. Operating time differed between groups, 87 versus 143 minutes for laparotomy and laparoscopy, respectively. Hospital stay was 6.2 days and 4.3 days, respectively. In the laparotomy group one patient experienced wound dehiscence and another had a vesicovaginal fistula requiring secondary repair. Complications in the laparoscopy group were one conversion to laparotomy because of bladder perforation and one case of septicemia that required laparotomy on the second postoperative day. Perioperative transfusions were administered to two women in the laparotomy group and none in the laparoscopy group.
Conclusion:
Laparoscopy may play an important role in treatment of early endometrial cancer. The procedure is difficult, however, and should be reserved to dedicated laparoscopists. It has low morbidity and, contrary to earlier recommendations, may be performed in older women with comorbidity.