Laparoscopic-Assisted Vaginal Hysterectomy versus Abdominal Hysterectomy in Stages I and II Endometrial Cancer: Operating Data, Follow up and Survival

Abordaje Laparoscópico en Cáncer De Endometrio

“…La laparoscopia tendría una recurrencia estadística-mente similar del 2,5-8,7% para estadío I (17,20,24) (Tabla II), sin embargo, algunos estudios reportan una mayor tasa de recidiva por vía abdominal de 14,9% vs 4% por laparoscopia (18). En conclusión, la sobrevida global y la tasa de recidiva no se vería afectada por la vía de abordaje, incluso habría una tendencia a una mayor sobrevida y menor tasa de recidiva en aquellas pacientes sometida a la vía laparoscópica vs abierta, que no es significativa, pero que probablemente en el futuro con nuevos estudios randomizados pueda existir.…”

“…Otro factor importante es la cantidad de ganglios resecados por vía laparoscópica, la cual oscila entre 14 y 18, similar a lo resecado por vía abdominal (16,21,22,24,(43)(44)(45) (Tabla III). Aparentemente la linfadenectomía laparoscópica con ultrasonido lograría un número mayor de ganglios (14 vs 18) y estos serían más fáciles de interpretar por el patólogo (46).…”

The Modern Surgical Strategy for Endometrial Cancer: Laparoscopic Surgery

“…Many retrospective studies [13][14][15][16][17][18][19][20][21][22][23][24][25], prospective nonrandomized studies [26][27][28][29], and meta-analyses [49•, 50-52, 53•] published during the last decade have suggested that laparoscopic surgery has an improved outcomes profile in terms of estimated blood loss and transfusion requirements, recovery of bowel movement, postoperative hospital stay, and perioperative complications compared with laparotomy in the surgical management of endometrial cancer. These findings have been confirmed in recent RCTs comparing laparoscopy and laparotomy for surgical staging of endometrial cancer (Table 1) The following discussion of outcomes and complications of laparoscopic surgery compared with laparotomy is based on the results of the eight RCTs presented in Table 1.…”

“…Indeed, whilst endometrial cancer is the first gynecologic cancer to be treated laparoscopically, a laparoscopic approach also is being used for the surgical management of malignant disease. Following the first report on the use of laparoscopic surgery for endometrial cancer by Childers et al [12], the feasibility, safety, and efficacy of laparoscopic surgery in the surgical management of endometrial cancer has been reported in numerous retrospective studies [13][14][15][16][17][18][19][20][21][22][23][24][25], prospective nonrandomized studies [26][27][28][29], or randomized, controlled trials (RCTs) [30][31][32][33][34][35][36][37][38][39][40][41][42]43 This review provides an update on the role of laparoscopic surgery for the surgical management of endometrial cancer with particular emphasis on feasibility, safety, and efficacy based on the results of randomized, controlled trials comparing laparoscopy and laparotomy for surgical staging of endometrial cancer.…”

Laparoscopy in Gynecology - How Why When

“…Laparoscopic approach is a longer operation but involves less blood loss, a shorter hospitalization, and fewer intraoperative and postoperative complications. [21][22][23] Cervical cancer Early cervical cancers are treated surgically, by radical abdominal hysterectomy and pelvic lymphadenectomy (RAH). The main difference between RAH and TAH is that during RAH, lymphatic tissue is removed lateral to the uterus.…”