Comparison of laparoscopy and laparotomy for management of endometrial carcinoma: a prospective randomized study with 11-year experience

Abstract

Laparoscopic surgery is a safe and reliable alternative to laparotomy in the management of endometrial carcinoma patients, with significantly reduced hospital stay and postoperative complications; however, it does not seem to improve the overall survival and 5-year survival rate, although multicenter randomized trials are required to evaluate the overall oncologic outcomes of this procedure.

Disease-Free and Survival Outcomes for Total Laparoscopic Hysterectomy Compared With Total Abdominal Hysterectomy in Early-Stage Endometrial Carcinoma: A Meta-analysis

“…Seven studies reported all safety outcomes, 3,15,17,18,20,21,24 conversion rates of TLH to TAH, and intraoperative and postoperative complications, and 2 reported information on postoperative complications only. 16,22 All patients had International Federation of Gynecology and Obstetrics (FIGO) stages I to IV endometrial cancer. For 3 studies, 16 The LACE 3 and LAP-2 4 studies were designed to establish NI of TLH and had prespecified NI margins of 7% at 4.5 years (LACE) and 5.3% at 3 years (LAP-2).…”

“…16,22 All patients had International Federation of Gynecology and Obstetrics (FIGO) stages I to IV endometrial cancer. For 3 studies, 16 The LACE 3 and LAP-2 4 studies were designed to establish NI of TLH and had prespecified NI margins of 7% at 4.5 years (LACE) and 5.3% at 3 years (LAP-2). For the LACE study, the NImargin at 3 years would be 4.9%, based on an exponential distribution and 3-year DFS rates of 93.2% (TAH) and 88.3% (TLH).…”

“…Six studies 3,4,16,17,19,23 reported the number of LRs and are summarized as proportions in Figure 2B (Supplementary Table 4, http://links.lww.com/IGC/A608). Local recurrence was defined as recurrence in the vagina, 4 vaginal vault 3,16 or vaginal cuff 23 in 4 studies; 1 study gave no definition.…”

Does the Type of Surgical Approach and the Use of Uterine Manipulators Influence the Disease-Free Survival and Recurrence Rates in Early-Stage Endometrial Cancer?

“…That fact is common in most of the studies published, 3,4,6,7,15 except of one. 13 It is also important to note that the development of the study coincided with the learning curve of the laparoscopic surgeons of our hospital, and this fact may have contributed to elongate the surgical procedure.…”

“…3,4,7 However, data related to recurrence rate and long-term survival are limited. 13 During laparoscopic approach, the upward traction to the uterus turns to be fundamental to achieve a successful procedure. That fact can be possible with the use of uterine manipulators in hysterectomy.…”