Elsevier

Gynecologic Oncology

Volume 86, Issue 2, August 2002, Pages 177-183
Gynecologic Oncology

Regular Article
Minilaparotomy in Early Stage Endometrial Cancer: An Alternative to Standard and Laparoscopic Treatment

https://doi.org/10.1006/gyno.2002.6721Get rights and content

Abstract

Objective. Our objective was to determine whether minilaparotomy could be a safe and feasible approach for the surgical treatment of early endometrial cancer patients and whether it could be considered a valid alternative to the laparoscopic treatment.

Methods. A pilot study of 50 consecutive patients with FIGO stage I–IV endometrial cancer undergoing surgery at our Department was performed between May and December 2001. All patients were evaluated for a minimal transabdominal approach. Exclusion criteria were considered: special hystotype, poorly differentiated tumors, clinical stage ≥Ic, Ca125 >35 U/ml, BMI >30, lymph nodal involvement assessed by MRI, and severe cardiopulmonary disease precluding steep Trendelemburg position.

Results. Twenty-six (52%) cases were considered eligible for minilaparotomy. The mean age was 55.4 years and the mean BMI was 24.1. All patients underwent TAH, BSO, pelvic lymphadenectomy ± omental or peritoneal biopsy. A mean number of 28 pelvic lymph nodes were removed. The mean operative time was 113.0 min and the mean intraoperative blood loss was 220.0 ml. There was 1 severe operative hemorrhage and 1 patient needed postoperative blood transfusion. No immediate complications of wound infection or separation occurred. The mean hospital stay was 3.4 days. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy, showing substantially comparable results.

Conclusion. Minilaparotomy is a feasible alternative to the standard treatment in endometrial cancer patients. It offers the patient a cost-effective procedure that avoids many of the potential complications of standard therapy, prevents long hospital recovery periods, and accomplishes all of the important goals of standard recommendations.

References (34)

Cited by (43)

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    A minilaparotomy incision defined as a transverse or vertical incision 3-5 cm in length can be considered an alternative to laparoscopy and is supported in specific settings as complementary to laparoscopy in adults.2,3 It is considered a minimally invasive surgical technique because it fulfills the criteria of a small and aesthetic abdominal incision.2,4 Small case series have described the minilaparotomy technique and its advantages in pediatrics, which include decreased risk of cyst rupture and more working space in a smaller abdominal cavity.4,5

  • Mini-Laparotomy Versus Laparoscopy for Gynecologic Conditions

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    Patients did not require repeat operation or hospital admission more frequently when undergoing mini-laparotomy, although this study was not designed to detect differences in these secondary outcomes. The present study confirms the findings of previous studies of mini-laparotomy that have retrospectively and prospectively demonstrated short operative times and minimal complication rates [12–17]. The study was not powered to detect differences in readmission, repeat operation, wound complications, and emergency room visits; however, there seems to be a trend toward equivalence.

  • Comparison of ultraminilaparotomy for myomectomy through midline vertical incision or modified Pfannenstiel incision-a prospective short-term follow-up

    2009, Fertility and Sterility
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    Both have been accepted as minimal access and less traumatic surgical methods (13). This less invasive procedure has been used in the management of various kinds of benign gynecologic diseases (14, 16, 19, 25), and some have used it in the management of malignant gynecologic diseases (26, 27), although there is some controversy regarding it use in the management of these diseases (28). In our previous study (13), we clearly demonstrated the potential for and the possible use of UMLT in place of conventional laparotomy in the management of uncomplicated uterine myomas, because of the many advantages of the former (UMLT), including less postoperative pain (less VAS) and better recovery.

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1

To whom correspondence should be addressed at Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy. Fax: +39-6-35508736. E-mail: [email protected].

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