Original articleLaparoscopic-assisted vaginal hysterectomy versus total laparoscopic hysterectomy for the management of endometrial cancer: A randomized clinical trial
Section snippets
Materials and methods
Consecutive women with endometrial cancer surgically managed from July 2003 through February 2005 in two academic gynecology departments were randomized to undergo either LAVH (LAVH group) or TLH procedure (TLH group). Women were offered the laparoscopic approach regardless of parity, body mass index (BMI), and surgical history. A uterine size ≥12 weeks, age over 75 years, severe cardiopulmonary comorbidity, and evidence of metastatic disease at preoperative workup were considered as exclusion
Results
During the study period, a total of 81 patients were referred to our departments for the surgical treatment of endometrial cancer. Of these, eight (9.9%) were not eligible for randomization because of a large uterus (n = 1), age over 75 (n = 5), and history of heart failure or pulmonary obstructive disease contraindicating prolonged Trendelenburg position (n = 2). In one patient the laparoscopic procedure was converted to laparotomy before randomization to control a significant hemorrhage
Discussion
A MEDLINE search using the terms “endometrial cancer,” “laparoscopy,” “laparoscopic-assisted vaginal hysterectomy,” and “total laparoscopic hysterectomy” revealed that this is the first randomized trial comparing LAVH and TLH for the surgical management of endometrial cancer. Our findings suggest that both LAVH and TLH are feasible and safe treatment options for women with endometrial cancer, with similar surgical outcomes. The difference in mean operative time between the study groups appears
References (34)
- et al.
Laparoscopically assisted surgical staging (LASS) of endometrial cancer
Gynecol Oncol.
(1993) - et al.
Comparison of laparoscopy and laparotomy in patients with endometrial cancer
J Am Assoc Gynecol Laparosc.
(2002) - et al.
Laparoscopic-assisted vaginal hysterectomy for endometrial cancerclinical outcomes and hospital charges
Gynecol Oncol.
(1999) - et al.
Surgical management of early-stage endometrial cancer in the elderlyis laparoscopy feasible?
Gynecol Oncol.
(2001) - et al.
Hysterectomy for obese women with endometrial cancerlaparoscopy or laparotomy?
Gynecol Oncol.
(2000) - et al.
Total laparoscopic hysterectomy for endometrial cancerpatterns of recurrence and survival
Gynecol Oncol..
(2004) - et al.
Total laparoscopic hysterectomy in the management of endometrial carcinoma
J Am Assoc Gynecol Laparosc.
(2002) - et al.
Total laparoscopic hysterectomy for oncological indications with outcomes stratified by age
Gynecol Oncol.
(2004) - et al.
Analysis of morbidity in patients with endometrial canceris there a commitment to offer laparoscopy?
Gynecol Oncol.
(2005) - et al.
Laparoscopy versus laparotomy in endometrial cancerfirst analysis of survival of a randomized prospective study
J Minim Invasive Gynecol.
(2005)