Introduction/Background Endometrial cancer is the third common gynecologic cancer in Thailand after cervical and ovarian cancer. Randomized controlled studies have demonstrated benefit of laparoscopic approach over conventional laparotomy in reduction in operative morbidity and hospital stay. However, laparoscopic approach for surgical staging in developing country, Thailand, is not yet widespread since surgical experience and national health insurance coverage. This study is a retrospective cohort study in single institute to evaluate perioperative outcomes of laparoscopic surgery for surgical staging in early stage endometrial cancer compared with those of the laparotomy approach.
Methodology Early stage endometrial cancer patients underwent surgical staging from January 2002 to June 2016 at Department of Obstetrics and Gynecology, Rajavithi Hospital, Thailand were extracted for review and matched by age and body mass index (BMI). Demographic data and clinicopathological features including data of perioperative outcomes were analyzed.
Results A total of 153 patients were included for our study. Eighty-four patients underwent conventional laparotomy and 69 received laparoscopic surgical staging. The demographic data including age, BMI, menopausal status, medical comorbidity and previous pelvic surgery were comparative between both groups. The operative time in laparoscopic surgery had significant longer, 233 min±55 min vs. 170±50 min (P<0.001) respectively. However, laparoscopy group had significant less blood loss (164±122 ml vs. 379±234 ml), shorter hospital stays (5±1 vs. 6±1 days) and needed less postoperative analgesic agents (P<0.001). The number of harvested pelvic lymph nodes, postoperative adjuvant treatment, perioperative complications of both groups were comparable.
Conclusion The laparoscopic approach in early stage endometrial cancer is feasible and harmless with better operative outcomes: shorter hospital stays, lesser blood loss and reducing postoperative pain with comparable oncological outcomes.
Disclosure Nothing to disclose.
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