Laparoscopic conversion rate for uterine cancer surgical staging

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery

Background:

• Endometrial adenocarcinoma is a common gynecologic malignancy.
• Laparoscopic staging is a standard surgical approach.
• Obesity presents challenges in gynecologic surgery.

Purpose of the Study:

• To determine the conversion rate of attempted laparoscopic staging for primary endometrial adenocarcinoma.
• To identify factors associated with conversion to open surgery.

Main Methods:

• A consecutive series of 235 patients with primary endometrial adenocarcinoma underwent attempted laparoscopic staging.
• No exclusion criteria were applied, including age, BMI, uterine size, or prior surgery.
• Data on operative outcomes and conversion rates were collected.

Main Results:

• The overall conversion rate to laparotomy or vaginal hysterectomy was 3% (6 out of 235 patients).
• All conversions occurred in patients with a body mass index (BMI) greater than 40 kg/m².
• Patients converted had a mean BMI of 66 kg/m².

Conclusions:

• Laparoscopic staging for endometrial adenocarcinoma is achievable with a low overall conversion rate.
• Patients with a BMI of 40 kg/m² or higher had a higher conversion rate (7%) compared to the overall cohort.
• Obesity is a significant factor influencing the success of laparoscopic staging in endometrial cancer.