Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in patients with early stage endometrial cancer

Kim, Min Kyu; Choi, Dong Seok; Kim, Woo Young; Choi, Chel Hun; Kim, Tae Joong; Lee, Jeong Won; Kim, Byoung Gie; Lee, Je Ho; Bae, Duk Soo

Abstract

OBJECTIVE
To compare laparoscopic surgery with conventional abdominal surgery in patients with early stage endometrial cancer.
METHODS
A retrospective review of 63 patients with early stage endometrial cancer managed between March 2003 and May 2005. Two groups were defined whether they had been treated by laparoscopy (case group: n=26) or by laparotomy (control group: n=37). We compared age, body mass index (BMI), hemoglobin change, operation time, number of pelvic lymph nodes, hospital stay, case with adjuvant treatment and recurrence between two groups.
RESULTS
There was no statistical difference in characteristics (age, BMI, nulliparity, previous abdominal surgery, FIGO stage, histologic grade). between case and control group. In addition, there was no statistical difference in operation data and outcomes between two groups. Hemoglobin changes were 1.1 g/dL (case group) vs 1.7 g/dL (control group) (p=0.072). Operation time was 131 min vs. 115 min. The numbers of lymph nodes obtained were 8.7 vs 7.7 (right) 9.2 vs. 7.6 (left). Hospital stays were 8.4 vs. 9.2 days. Adjuvant treatment cases were 7 vs. 15. Recurrent case was one in each group. Two patients initially evaluated by laparoscopy were converted to laparotomy due to bleeding and adhesion.
CONCLUSION
Laparoscopic surgery for treatment of early endometrial cancer is a safe and effective alternative to laparotomy . However, long-term survival and risk of recurrence have yet to be determined.