Safety of total laparoscopic modified radical hysterectomy with or without lymphadenectomy for endometrial cancer

Abstract

Study objective:In order to reduce the risk of vaginal recurrence, we have chosen total laparoscopic modified radical hysterectomy instead of extrafascial hysterectomy in the treatment of endometrial cancer. The aim of this study was to assess the safety of this method.Design:Retrospective study of gynecological patients.Setting:Yokohama City University Medical Center, Yokohama, Japan.Patients:Forty-nine patients who underwent total laparoscopic modified radical hysterectomy for the treatment of endometrial cancer at our hospital between December 2011 and September 2015.Interventions:Total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy (n = 20), total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic lymphadenectomy (n = 18), or total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic and para-aortic lymphadenectomy (n = 11).Measurements and Main Results:The surgical outcomes were analyzed and compared to previous reports. The median operative time was 204 minutes (range, 99–504 minutes) and the median intraoperative blood loss was 150 mL (range, 0–680 mL). No patients needed a blood transfusion, conversion to laparotomy, or reoperation. Intra- and postoperative complications were observed in three patients and nine patients, respectively. The amount of blood loss and the incidence of complications in our study were almost identical to previous reports of laparoscopic hysterectomy. The operative time in our study was equivalent to previous reports of total laparoscopic modified radical hysterectomy.Conclusion:Total laparoscopic modified radical hysterectomy is safe and feasible for the treatment of early stage endometrial cancer. This procedure can be an alternative to total laparoscopic hysterectomy, especially when the uterus must be removed completely.

Is it the time for laparoscopic management of early-stage ovarian malignancies?

“…This approach offers a means to decrease the morbidity associated with open surgery without compromising oncologic outcome. [ 1 2 3 4 5 6 ] However, the acceptance of laparoscopy for surgical staging women with ovarian cancer remains controversial. Questions remain about the adequacy, feasibility, and standardization of laparoscopic technique, the possible risks of tumor metastases, and impact on survival outcome.…”

Late retroperitoneal hematoma with abscess formation following laparoscopic staging of endometrial cancer

“…Hematoma formation after laparoscopic surgical staging for endometrial cancer has been reported to be 0.5–2%. [ 1 4 6 7 ] Unlike major vascular injuries that can be catastrophic, hematomas may have a more insidious course. Tinelli et al .…”

“…Abscess formation after laparoscopic surgical staging for endometrial cancer has been reported to be ~1%. [ 3 6 7 8 ] In a retrospective study of 30 patients who underwent total laparoscopic hysterectomy and lymphadenectomy for endometrial cancer, one case of pelvic abscess was reported and managed with IV antibiotics and CT-guided drainage. CT-guided percutaneous drainage is an effective, well-established, non-invasive means of treatment of pelvic abscess.…”

“…Laparoscopic surgical staging for endometrial cancer has been shown to be feasible and safe, with lesser early complications and shorter hospital stay than traditional laparotomy. [ 1 2 3 4 5 6 ]…”

Minimally invasive therapy for cancer: It is time to take actions for training system in minimally invasive therapy after lacc report

“…[1] He has found out that the conceptions of minimally invasive therapy (MIT) for cervical cancer is not the same as those in our study and recent research. [2345678910] Dr. Walker's LAP2 study in 2009 reveals that laparoscopic-assisted staging surgery for endometrial cancer has the same 5-year survival rate as laparotomy. In comparison with laparotomy, laparoscopic-assisted staging surgery for endometrial cancer has much lower hospitalization time, blood loss, and comorbidities.…”