Risk Factors for Surgical Treatment of Endometrial Cancer Using Traditional and Laparoscopic Methods

Abstract

Surgical treatment is the most important part of therapy for endometrial cancer. The aim of the study was to define factors having the most significant impact on surgical treatment of endometrial cancer when using traditional and laparoscopic methods. In the study, we evaluated 75 females who were treated for endometrial cancer via laparoscopic surgery in 2019 and used a historical control of 70 patients treated by laparotomy in 2011. The evaluated risk factors included the method of surgery, type of lymphadenectomy, patient’s age, various obesity parameters, histological grading, cancer clinical staging, pelvic dimensions, previous abdominal surgeries, comorbidities, and number of deliveries. The duration of hospitalization, operation time, loss of hemoglobin, and procedure-related complications were used as parameters of perioperative outcomes. Multivariable linear regression analysis confirmed the following factors as being predictors of worse perioperative outcomes: laparotomy, abdominal obesity (waist circumstance and waist-to-hip ratio), range of lymphadenectomy, prior abdominal surgeries, and larger pelvic dimensions. Abdominal obesity is a significant risk factor in the treatment of endometrial cancer. Laparotomy continues to be utilized frequently in the management of endometrial cancer in Poland as well as elsewhere, and adopting a minimally invasive approach is likely to be beneficial for patient outcome.

Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

“…In addition, laparoscopic surgery is performed in a relatively closed abdominal cavity, and the pelvic and abdominal organs do not need to be exposed for a long time, and the intestinal tract will not be dry and cold, so that the patient's gastrointestinal motility function can be quickly recovered after surgery. [49][50][51] There are no significant differences in recurrence and survival between LRH and ARH. A long-term follow-up study 52 has found that the 5-year survival rate after LRH was basically the same as that of laparotomy.…”

“…The possible reason for the difference may be that laparoscopic surgery avoids the touch of the abdominal retractor, gauze and operator’s gloves on the intestine, and the less intestinal tract manipulations in the LRH reduce irritation to the patient’s gastrointestinal tract. In addition, laparoscopic surgery is performed in a relatively closed abdominal cavity, and the pelvic and abdominal organs do not need to be exposed for a long time, and the intestinal tract will not be dry and cold, so that the patient’s gastrointestinal motility function can be quickly recovered after surgery 49–51…”