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470 Endometrial cancer – the surgical treatment in the hands of residents of Oncological Gynaecology supervised by specialists
  1. M Mrugała,
  2. K Nowak,
  3. A Machnicka-Rusek,
  4. M Kalus,
  5. J Tomiczek-Siwiec,
  6. B Samborska,
  7. Z Borowiec and
  8. E Milnerowicz-Nabzdyk
  1. SPZOZ Opolskie Centrum Onkologii im. prof. Tadeusza Koszarowskiego, Opole, Poland


Introduction/Background*Endometrial cancer is the most common of gynaecological malignant neoplasms in Europe and developed countries. Early diagnosis guarantees higher chances of recovery and the characteristics of this cancer allow us to treat it in a minimally invasive way which brings many benefits for the women.

This is the reason for such a big significance of excellent training in laparoscopic and robotic surgery amongst trainees in Gynaecological Oncology.

Methodology The patients with diagnosed endometrial cancer in FIGO stages I and II were sequentially assigned to two groups to gather 50 of each: laparoscopic and open surgery. The open procedures were performed by teams comprised of 2 doctors and the laparoscopic were performed by 3 doctors in the team. All of the surgeries were carried out by trainees in Gynaecological Oncology and supervised by a specialist. The qualifications for a total hysterectomy with bilateral salpingo-oophorectomy and lymph node staging were based on ESGO recommendations. Two groups were compared in the following fields: age, BMI, time of the procedure, total number of dissected pelvic and paraaortic lymph nodes, complications, postoperative hospital stay.

Result(s)*Most of the results obtained were similar in both groups. The average age of the participants in both groups was 64,57 years (laparoscopy: 63,48 years, open surgery: 66,35 years), BMI was 31,49 kg/m2 (31,67 vs 31,25 kg/m2). The quantity of dissected lymph nodes during laparoscopy was 21,2 pelvic nodes and 12,4 paraaortic nodes per procedure and respectively 23,76 and 12,9 for laparotomy. The rate of complications was equal in both groups (n=6). Significant differences were observed in two areas. The time of surgery was longer in a laparoscopic group (181 minutes) vs. 141 minutes for open surgery. The postoperative stay took 3 days after the minimally invasive procedure and 6 days after laparotomy.

Conclusion*The outcome of surgical treatment performed by trainees was comparable in both groups.The minimally invasive surgery group had many benefits as quick recovery, great precision of surgery with an adequate oncological accuracy. The longer duration of laparoscopic procedures is a result of a learning curve.

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