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Staging endometrioid adenocarcinoma. Clinical and financial comparison of laparoscopic and traditional approaches
1Department of Obstetrics and Gynecology, Fallon Clinic, Worcester, Massachusetts, USA.
Objective:
To compare laparoscopically assisted surgical staging (LASS) of endometrioid adenocarcinoma with traditional surgical staging by laparotomy.
Study Design:
A retrospective review of all cases of uterine cancer (n = 108) insured by one health maintenance organization during 1990-1995. During this period, 29 patients underwent successful LASS and were compared to 64 who underwent laparotomy for treatment of surgical stage I endometrioid adenocarcinoma.
Results:
LASS was performed successfully in 29 of 32 attempted cases. All patients on whom LASS was attempted were found to have surgical stage I. Laparoscopic pelvic lymphadenectomy was highly successful, with no failures and a mean number of 14 nodes obtained. The overall complication rate was significantly higher for laparotomy than for LASS (28% vs. 7%, P < .001). The average length of stay for laparotomy was significantly higher than for LASS (5.1 vs. 2.3 days, P < .001).
Conclusion:
LASS for stage I endometrioid adenocarcinoma is an attractive alternative to traditional surgical staging. It causes fewer complications and shortens the hospital stay.