Laparoscopic surgery of endometrial cancer. Preliminary results of a multicentric study

Objective To analyse the results of laparoscopic management of women with endometrial cancer, and comparison with the open technique. Design Prospective multicentre study. Setting Department of Gynaecology: Hospital for Infants, Kladno, Czech Republic. Subjects 76 women who underwent laparoscopic surgery and open procedures for endometrial cancer. Main outcome measures The differences between both the peri- and postoperative outcomes were evaluated. Results Two patients whose surgery was completed by laparotomy were excluded from the study The other 43 laparoscopic procedures were successfully completed. Laparoscopic hysterectomy and pelvic and paraaortic lymphadenectomies were carried out, based on the grade of the tumour and the depth of myometrial invasion. Of the patients, 19 underwent pelvic lymphadenectomy and 14 women also had para-aortic lymph node sampling dissection. Five of these patients had positive pelvic or paraaortic nodes. The mean operating time was 178 min vs. 151 min in the control open group. There were no major complications. Conclusions The laparoscopic approach to surgery for early stage endometrial carcinoma is an attractive alternative to the conventional surgical approach. The advantages of laparoscopic surgery are patient related. Because an abdominal incision is avoided, recovery time is reduced. The major obstacle to incorporating operative laparoscopy into gynaecological oncology is the lack of controlled studies demonstrating its ability to improve current management.