Comparison of Laparoscopy and Laparotomy for Management of Endometrial Carcinoma: A Meta-analysis

Abstract

The survival outcome and recurrence rate after laparoscopic surgery for endometrial carcinoma were similar to those in the laparotomy procedures. However, the complication rate was lower after laparoscopy compared with laparotomy.

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

“…As to the complications, there was a lower risk of postoperative complications in patients undergoing TLH, but there was no difference in risks of both intra-operative and complications, confirming the results previous two meta-analyses (Ju et al, 2009;Palomba et al, 2009). However, previous meta-analyses didn't assess the safety of TLH in terms of major complications and total complications (Ju et al, 2009;Palomba et al, 2009).…”

“…The outcomes from these two new randomized studies were also inconsistent from each other in terms of the safety of TLH (Janda et al, 2010;Mourits et al, 2010). Besides, previous meta-analyses didn't include studies published in Chinese, which could cause the selection bias (Ju et al, 2009;Palomba et al, 2009). Thus, in order to obtain a more consistent appraisal of the evidence regarding the effects of TLH to endometrial cancer, we conducted a meta-analysis of randomized trials quantitatively regarding clinical outcomes including complication rates and mortality rate.…”

“…Two meta-analyses have been published to give a comprehensive review on the effects of TLH compared with TAH (Ju et al, 2009;Palomba et al, 2009). However, previous randomized studies of TLH versus TAH in patients with endometrial cancer are limited, and more importantly, are not powered enough to give a precise estimate of the effects (Ju et al, 2009;Palomba et al, 2009). Two new randomized studies with large sample size were published to further assess the safety of TLH (Janda et al, 2010;Mourits et al, 2010).…”

“…Besides, to ensure uniformity in defining both patient characteristics for endometrial cancer and clinical efficacy measures, a meta-analysis of individual patient data is needed (Simmonds et al, 2005). Second, the clinical outcomes of TAH or TLH and bilateral salpingooophorectomy and/or pelvic and/or para-aortic lymph node dissection differed, but we didn't perform subgroup analyses according to the combined treatment status such as salpingooophorectomy and/or pelvic and/or para-aortic lymph node dissection owing to the limited studies reported in the original papers (Ju et al, 2009;Palomba et al, 2009;Kehoe and Miller, 2011;Saso et al, 2011). Thus, further studies could compare TAH and TLH according to the different status of the combined treatment.…”

“…However, previous meta-analyses didn't assess the safety of TLH in terms of major complications and total complications (Ju et al, 2009;Palomba et al, 2009). Our meta-analysis shows that TLH was associated with lower risks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI 0.42-0.82, P = 0.002), which suggest TLH is safer than TAH for patients with endometrial cancer.…”