Introduction/Background We aimed to assess the feasibility and survival outcomes of laparoscopic surgical staging for patients with early-stage ovarian cancer compared with laparotomic approach.
Methodology Retrospective observational study which included forty-six patients who underwent laparoscopy (20 patients) or laparotomy (26 patients) for surgical staging of early-ovarian cancer between 2010 and 2018 were included. We analyzed clinical data and compared surgical and survival outcomes of both approaches.
Results Mean age was 60±20 years. Nineteen patients were classified as stage IA, 22 as stage IC, 2 as stage IIA and 3 as stage IIB. Histological types included: serous in 16, mucinous in 5, clear cell in 10 and endometrioid in 6 patients, 9 cases were classified as others, including carcinoid, yolk-sac, disgerminoma, granulosa-cell and seromucinous.
The laparoscopy group compared to the laparotomy group presented significantly shorter hospital stay (4,8 vs.9,2 days) and lower complication rate (2% vs. 22%).
In the laparotomy group 1 patient presented intraoperative vascular injury and another urologic injury. Postoperatively 2 patients presented respiratory infection, 3 urinary infection, 1 haemorrhage, 1 paralytic ileus and 1 asymptomatic lymfocele. In the laparoscopy group no patients presented intraoperative complications. Postoperatively, 1 patient presented symptomatic lymfocele.
Intraoperative blood loss tended to be lower in laparoscopy (197,1 vs 459,1 ml), although the difference was not statistically significant(p=0,07).
No significant differences were found in operative time, number of removed lymph nodes, intraoperative tumour rupture rate, postoperative chemotherapy, recurrence or survival rates.
Thirteen patients presented disease recurrence; 10 of which had undergone laparotomy.
Overall survival was 93%, with a median follow-up of 37 months.
Conclusion Laparoscopic staging performed by a trained gynaecologic-oncologist is a safe and effective alternative for early ovarian cancer. It has the advantage of minimum invasiveness, providing a shorter hospital stay and faster recovery, whilst preserving the requirements of an optimal surgery and the survival outcomes compared to laparotomic approach.
Disclosure Nothing to disclose.
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