The Adoption of Single-port Laparoscopy for Full Staging of Endometrial Cancer: Surgical and Oncology Outcomes and Evaluation of the Learning Curve

Barnes, Hayley; Harrison, Ross; Huffman, Laura; Medlin, Erin; Spencer, Ryan; Al-Niaimi, Ahmed

doi:10.1016/j.jmig.2017.06.017

Cited by 15 publications

(12 citation statements)

References 12 publications

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“…In their 2014 report, Fagotti et al reported that the operation time for total hysterectomy BSO, and BPLND via SILS was 142 min, which increased to 192 min if PALND was performed 19 . Barnes et al reported their results with SILS in 2017, and their operation time was 186 min with total hysterectomy, BSO, BPLND, and PALND 8 . The skill level of these experts must have significantly influenced their results.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison, Barnes et al evaluated SILS for EC and reported reduction of operation time after 80 cases (191-152 min) with at least 6 months of experience in SILS surgery before starting surgical staging 8 . The author advised that any surgeon intending to apply full uterine cancer staging should undergoes the general learning curve of SILS before adopting lymphadenectomy 8 . The complex technical requirements and instruments may make adopting this approach challenging.…”

Section: Discussionmentioning

confidence: 99%

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Two-port access for laparoscopic surgery for endometrial cancer using conventional laparoscopic instruments

Huang

Sheu

et al. 2021

Sci Rep

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Minimally invasive surgery is the first-line management for endometrial cancer. The role of 2-port access laparoscopy (TPA) has been underestimated. Compared to conventional laparoscopic surgery (CL), TPA is associated with smaller total incision size and less postoperative pain. Compared to single-incision laparoscopic surgery, no specific instruments and surgical techniques are needed. This study primarily evaluated the surgical and pathologic outcomes of TPA with conventional instruments, and additionally evaluated the surgeon’s learning curve. Consecutive patients who underwent TPA and CL for endometrial cancer between 2015 and 2019 were included. Baseline characteristics were recorded. In total, 148 patients (TPA, 89; CL, 59) were identified. The baseline characteristics were similar, except for a greater proportion of patients in the CL group receiving para-aortic lymph node dissection (5.62% vs. 35.59%, P < 0.01). The mean operation time was significantly less in the TPA group (152.09 vs. 187.15 min; P < 0.01). Both the groups had comparable 5-year progression-free survival (TPA, 86.68%) and 5-year overall survival rates (TPA, 93.24%). Analysis of the learning curve showed that the operation time decreased after 3–4 procedures. TPA using conventional laparoscopic instruments for endometrial cancer is feasible and is easily accessible to patients and surgeons.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Two-port access for laparoscopic surgery for endometrial cancer using conventional laparoscopic instruments

Huang

Sheu

et al. 2021

Sci Rep

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“…Although in the gynecological field the use of single-port for pelvic lymphadenectomy for surgical staging of early uterine cancer is established, 11 – 12 there are still no reports on the use of the laparoscopic single-port approach to make a diagnosis or to follow the progression of a lymphoproliferative disease. This is the reason why we wanted to investigate the feasibility and effectiveness of this approach in giving a valid diagnostic response when compared to traditional laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…The main experiences are those described by gynecologists for pelvic lymphadenectomy for surgical staging of early uterine cancer. 11 – 12 …”

Section: Introductionmentioning

confidence: 99%

Single-Port vs. Conventional Multi-Port Laparoscopic Lymph Node Biopsy

Casaccia¹,

Fornaro²,

Papadia³

et al. 2020

JSLS

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Background and Objectives: The purpose of the investigation was to compare clinical results and diagnostic accuracy for conventional multiport laparoscopic lymph node biopsy (MPLB) and single-port laparoscopic lymph node biopsy (SPLB) operations at a single institution. Methods: A set of 20 SPLB patients operated on from October 2016 to May 2019 were compared to an historical series of 35 MPLB patients. Primary endpoints were the time of surgery, estimated blood loss, surgical conversion, length of stay and morbidity. The secondary endpoint was the diagnostic accuracy of the technique. Results: SPLB was completed laparoscopically in all cases. Two MPLB patients (5.7%) experienced a surgical conversion due to intraoperative difficulties. Duration of surgery was similar in SPLB and MPLB groups respectively (84 ± 31.7 min vs. 81.1 ± 22.2; P = .455). A shorter duration of hospital stay was shown for patients operated on by SPLB compared to the MPLB group (1.7 ± 0.9 days vs. 2.1 ± 1.2 days; P = .133). The postoperative course was uneventful in both groups. In 95% of the SPLB and 97.1% of the MPLB cases respectively, LLB achieved the necessary information for the diagnosis. Conclusion: SPLB has shown good procedural and postoperative outcomes as well as a high diagnostic yield, comparable to traditional MPLB. Therefore, our results show that this approach is safe and effective and can be an equally valid option to MPLB to obtain a diagnosis or to follow the progression of a lymphoproliferative disease. Further studies are necessary to support these results before its widespread adoption.

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“…Although our team had carried out multi-port laparoscopic gynecological malignant tumor surgery for many years, it was in the year of 2018 that the single port laparoscopic endometrial cancer staging surgery was carried out. In 2017, Barnes et al [9] retrospectively analyzed 110 cases of single port laparoscopic endometrial cancer comprehensive staging surgeries, and compared the last 30 cases with the rst 20 cases in the study cohort. The results indicated that after the rst 20 surgeries, the surgeries time, intraoperative blood loss and complication rate decreased signi cantly.…”

Section: Follow-upmentioning

confidence: 99%

The Feasibility and Effects in Full Staging Surgery of Endometrial Cancer by Combination of Transumbilical Single-port Laparoscopy and ERAS

Cai

Chen

Wang

et al. 2021

Preprint

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BackgroundsTo study the safety, feasibility and aesthetics of transumbilical single port laparoscopic technology combined with accelerated rehabilitation surgery in stage I endometrial cancer staging surgery, and whether the laparoscopic surgery is a factor affecting the prognosis of endometrial cancer. MethodsA total of 93 patients with type I endometrial cancer stage I were enrolled in this study, including 31 cases and 62 cases in the single port and multi-port laparoscopic groups, respectively. Both groups received ERAS technology to compare the intraoperative and postoperative conditions. Subsequently, the medical records of 62 patients who had undergone open surgery were collected, and the survival, recurrence and death of the single port laparoscopic group, the multi-port laparoscopic group and the open surgery group were compared through survival analysis. ResultsThe time of surgery, intraoperative blood loss and fluid infusion volume in the single port group and the multi-port group were significantly less than those of the multi-port group (P<0.05). The single-hole group was better than the open group in terms of rapid postoperative recovery, hospitalization days, incision abdominal incision cometic effect, physical function, physical pain, vitality, and mental health (P<0.05). And there is no significant differences of mortality and recurrence among single port, multi-port and open surgery (P>0.05). Laparoscopic surgery is not a risk factor affecting OS and DFS in patients with endometrial cancer. ConclusionsTransumbilical single port laparoscopy combined with ERAS was safe and feasible for the treatment of stage I endometrial cancer with good cosmetic results and more advantages than multi-port laparoscopy.

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The Adoption of Single-port Laparoscopy for Full Staging of Endometrial Cancer: Surgical and Oncology Outcomes and Evaluation of the Learning Curve

Cited by 15 publications

References 12 publications

Two-port access for laparoscopic surgery for endometrial cancer using conventional laparoscopic instruments

Two-port access for laparoscopic surgery for endometrial cancer using conventional laparoscopic instruments

Single-Port vs. Conventional Multi-Port Laparoscopic Lymph Node Biopsy

The Feasibility and Effects in Full Staging Surgery of Endometrial Cancer by Combination of Transumbilical Single-port Laparoscopy and ERAS

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