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Laparoendoscopic Single-Site Versus Conventional Laparoscopic Surgical Staging for Early-Stage Endometrial Cancer
  1. Jeong-Yeol Park, MD, PhD,
  2. Dae-Yeon Kim, MD, PhD,
  3. Dae-Shik Suh, MD, PhD,
  4. Jong-Hyeok Kim, MD, PhD and
  5. Joo-Hyun Nam, MD, PhD
  1. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
  1. Address correspondence and reprint requests to Joo-Hyun Nam, MD, PhD, Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, South Korea. E-mail: jhnam{at}amc.seoul.kr.

Abstract

Objective This study aims to compare the feasibility, safety, and efficacy of laparoendoscopic single-site (LESS) surgical staging for early-stage endometrial cancer with conventional laparoscopic surgical staging.

Materials and Methods The prospective study group consisted of 37 consecutive patients who underwent LESS surgical staging including hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The historical control group consisted of 74 consecutive patients who underwent 4-port laparoscopic surgical staging including hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Surgical outcomes were compared between the 2 groups.

Results No patient in the LESS or conventional laparoscopic surgery group required an additional trocar or conversion to laparotomy. There were no intergroup differences in mean age, menopause status, body mass index, and previous history of abdominal surgery. Further, there were no inter-group differences in the number of total (LESS vs. conventional, 25.9 ± 10.6 vs. 24.6 ± 9.0, P = 0.497), pelvic (24.6 ± 0.497 vs. 23.3 ± 7.7, P = 0.459), and para-aortic (4.9 ± 2.5 vs. 6.9 ± 7.3, P = 0.494) lymph nodes retrieved; the operating time (183 ± 50 min vs. 173 ± 106, P = 0.388); estimated blood loss (194 ± 149 mL vs. 173 ± 106 mL, P = 0.394); number of patients requiring transfusion (5.4% vs. 8.1%, P = 0.717); postoperative hospital stay (5.0 ± 1.8 days vs. 5.1 ± 1.8 days, P = 0.911); intraoperative complications (2.7% vs. 0%, P = 0.333); and postoperative complications (0% vs. 1.4%, P > 0.999). The postoperative pain scores and analgesic requirements were significantly lower in the LESS surgical staging group.

Conclusions Laparoendoscopic single-site surgical staging was a feasible, safe, and efficacious procedure for surgical management of early-stage endometrial cancer. It was associated with less postoperative pain and analgesic requirements and was comparable to conventional laparoscopic surgical staging in perioperative outcomes.

  • Endometrial cancer
  • Laparoscopy
  • Laparoendoscopic single-site surgery
  • Surgical staging

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Footnotes

  • The authors declare 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 (www.ijgc.net).

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