Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Wang, Huiling; Ren, Yulong; Yang, Jun; Qin, Ruiying; Zhai, Kaihua

doi:10.7314/apjcp.2013.14.4.2515

Cited by 25 publications

(12 citation statements)

References 32 publications

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“…Endometrial cancer is the most common gynecologic cancer treated with laparoscopic surgery. It is feasible and has less operative morbidity, less blood loss, shorter hospitalizations, and better short-term quality of life than the laparotomy approach (Kornblith et al, 2009;Galaal et al, 2012;Wang et al, 2013). Similar results were reported for laparoscopic radical hysterectomy in cervical cancer (Magrina et al, 2008).…”

Section: Introductionsupporting

confidence: 74%

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Manchana

Sirisabya²,

Vasuratna³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To determine surgical outcomes, perioperative complications, and patient outcomes in gynecologic cancer patients undergoing robotic surgery. Materials and Methods: Surgical outcomes, including docking time, total operative time, console time, estimated blood loss (EBL), conversion rate and perioperative complications were retrospectively reviewed in 30 gynecologic cancer patients undergoing robotic surgery. Patient outcomes included recovery time and patient satisfaction, as scored by a visual analogue scale (VAS) from 0-10. Results: The operations included 24 hysterectomies with pelvic lymphadenectomy (PLD) and/or para-aortic lymphadenectomy, four radical hysterectomies with PLD, and two radical trachelectomies with PLD. Mean docking time was 12.8±9.7 min, total operative time was 345.5±85.0 min, and console time was 281.9±78.6 min. These times were decreased in the second half of the cases. There was no conversion rate. Three intraoperative complications, including one external iliac artery injury, one bladder injury, and one massive bleeding requiring blood transfusion were reported. Postoperative complications occurred in eight patients, most were minor. Only one patient had port herniation that required reoperation. Mean hospital stay was 3.5±1.7 days, and recovery time was 14.2±8.1 days. Two-thirds of patients felt very satisfied and one-third felt satisfied; the mean satisfaction score was 9.4 +0.9. Two patients with stage III endometrial cancer developed isolated port site metastasis at five and 13 months postoperatively. Conclusions: Robotic surgery for gynecologic cancer appears to be feasible, with acceptable perioperative complication rate, fast recovery time and high patient satisfaction.

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Section: Introductionsupporting

confidence: 74%

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Manchana

Sirisabya²,

Vasuratna³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Surgery is the mainstay of staging and treatment but chemotherapy and radiotherapy are also used in selected patients. Total laparoscopic hysterectomy or total abdominal hysterectomy may be preferred options (Wang et al, 2013). Observation, whole pelvic radiotherapy, brachytherapy and chemotherapy are all treatment options recommended for stage IB disease in NCCN guidelines but which treatment for which particular patient is not clear.…”

Section: Discussionmentioning

confidence: 99%

Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

Rahatli

Dizdar²,

Küçüköztaş³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…To obtain more consistent evidence regarding the effects of laparoscopy in EEC, Wang et al recently conducted a meta-analysis of randomized trials quantitatively evaluating clinical outcomes including complications and mortality rate [10]. Wang et al confirmed the results of 2 previous meta-analyses [8,20], showing evidence of a benefit for laparoscopy over laparotomy in the surgical staging of women with EEC (Table 2).…”

Section: Surgical Approach With Eec (Stage I Figo2009)mentioning

confidence: 88%

Surgical Management of Early Endometrial Cancer: An Update and Proposal of a Therapeutic Algorithm

et al. 2014

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In the last few years technical improvements have produced a dramatic shift from traditional open surgery towards a minimally invasive approach for the management of early endometrial cancer. Advancement in minimally invasive surgical approaches has allowed extensive staging procedures to be performed with significantly reduced patient morbidity. Debate is ongoing regarding the choice of a minimally invasive approach that has the most effective benefit for the patients, the surgeon, and the healthcare system as a whole.Surgical treatment of women with presumed early endometrial cancer should take into account the features of endometrial disease and the general surgical risk of the patient. Women with endometrial cancer are often aged, obese, and with cardiovascular and metabolic comorbidities that increase the risk of peri-operative complications, so it is important to tailor the extent and the radicalness of surgery in order to decrease morbidity and mortality potentially derivable from unnecessary procedures. In this regard women with negative nodes derive no benefit from unnecessary lymphadenectomy, but may develop short- and long-term morbidity related to this procedure. Preoperative and intraoperative techniques could be critical tools for tailoring the extent and the radicalness of surgery in the management of women with presumed early endometrial cancer. In this review we will discuss updates in surgical management of early endometrial cancer and also the role of preoperative and intraoperative evaluation of lymph node status in influencing surgical options, with the aim of proposing a management algorithm based on the literature and our experience.

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Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Cited by 25 publications

References 32 publications

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Feasibility and Safety of Robotic Surgery for Gynecologic Cancers

Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

Surgical Management of Early Endometrial Cancer: An Update and Proposal of a Therapeutic Algorithm

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