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Two-Port Access Versus Conventional Staging Laparoscopy for Endometrial Cancer
  1. Jiheum Paek, MD*,
  2. Eun Ji Nam, MD, PhD,
  3. Maria Lee, MD,
  4. Ga Won Yim, MD,
  5. Sunghoon Kim, MD,
  6. Young Tae Kim, MD, PhD and
  7. Sang Wun Kim, MD, PhD
  1. * Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon; and
  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
  1. Address correspondence and reprint requests to Sang Wun Kim, MD, PhD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, 120-752 Seoul, Republic of Korea. E-mail: san1{at}yuhs.ac.

Abstract

Objective The purpose of this study was to compare surgical outcomes of 2-port access (TPA) and conventional laparoscopy in staging operations for endometrial cancer. The ultimate goal of TPA system was to perform proper cancer operation with less invasive access and to complement technical limitations of minimally invasive surgery.

Methods The TPA system consisted of a single multi-channel port system at the umbilicus and an ancillary 5-mm trocar in the suprapubic area. Twenty-one consecutive patients who underwent TPA staging laparoscopy for endometrial cancers were enrolled in the study. Data coming from this group of patients were prospectively collected and compared with those coming from 42 consecutive patients who underwent conventional staging laparoscopy for the same period. The selected patients were matched (1:2 ratio) to control patients based on age (± 5 years), body mass index, and tumor stage.

Results Patient status was estimated in operative morbidity and surgical outcomes. All operations were completed laparoscopically, with no conversion to laparotomy. The TPA group had a significantly longer operating time (238 ± 51 minutes vs 188 ± 65 minutes; P = 0.001), more retrieved para-aortic lymph nodes (13 vs 5; P < 0.001), shorter postoperative hospital stay (5 vs 8 days; P = 0.001), and less postoperative pain (P = 0.045). There were no postoperative complications requiring further management.

Conclusions Two-port access staging laparoscopy using a single multi-channel port system could be a feasible procedure in selected patients with endometrial cancer with only minimal skin incisions. Prospective randomized trials will permit the evaluation of potential benefits of this minimally invasive surgical technique.

  • Two-port
  • Laparoscopy
  • Endometrial cancer

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Footnotes

  • This study was supported by the Brain Korea (BK) 21 project for medical sciences, Yonsei University and by National Research Foundation of Korea Grant funded by the Korean Government (2009-0071158).

  • All authors declare that there are no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (http://www.ijgc.net).

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