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Surgical treatment of endometrial cancer and atypical hyperplasia: a trend shift from laparotomy to laparoscopy.

Qvigstad E, Lieng M - Obstet Gynecol Int (2011)

Bottom Line: Laparoscopic hysterectomy has proved to be a safe alternative to open surgery in women with benign indications.Moreover, the laparoscopic technique was increasingly applied in older women, more obese women and in women with high-risk preoperative diagnosis, without increasing the complication rate.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology, Oslo University Hospital Ullevål and University of Oslo, 0407 Oslo, Norway.

ABSTRACT
Background. Laparoscopic hysterectomy has proved to be a safe alternative to open surgery in women with benign indications. Few studies compare laparotomy and laparoscopy in gynecologic oncology, and the objective of this study was to analyze the feasibility and development of laparoscopic surgery in endometrial cancer patients. Material and Methods. Records from all women having a hysterectomy due to premalignant or malignant endometrial changes during the years 2002-2009 were examined retrospectively. Results. A total of 521 hysterectomies were performed during the study period. Laparoscopy was performed in about 20% of the cases in the first two years, increasing to 83% in the last year of the period. Moreover, the laparoscopic technique was increasingly applied in older women, more obese women and in women with high-risk preoperative diagnosis, without increasing the complication rate. Conclusions. As for benign indications, laparoscopic hysterectomy in endometrial cancer patients should be preferred whenever possible.

No MeSH data available.


Related in: MedlinePlus

Mean age of women having laparoscopic and open abdominal procedures in 2002–2009.
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fig3: Mean age of women having laparoscopic and open abdominal procedures in 2002–2009.

Mentions: In the early study period, women who were treated by laparoscopy had a lower BMI compared to women who underwent laparotomy. As illustrated in Figure 2, this has changed through the eight-year period, and women who had laparoscopic procedure in the last few years had higher BMI compared to the laparotomy group. Previously, advanced laparoscopic procedures were more unusual in older patients, and the average age of the included patients were almost 64 years. As observed for obesity, there has been a tendency with more laparoscopic procedures in older patients through the eight-year study period (Figure 3). A similar tendency was seen when preoperative histological diagnosis was examined in relation to the surgical approach. In 2002, all women with a high-risk preoperative histology (endometrioid adenocarcinoma with low tumour differentiation, clear cell, and serous papillary carcinoma) were treated by an open abdominal approach. Even though the laparoscopy procedures have varied among these patients through the years, a reasonable number of patients have experienced the benefits of minimally invasive surgery, and, in the last registered year (2009), two thirds of these patients had laparoscopic surgery.


Surgical treatment of endometrial cancer and atypical hyperplasia: a trend shift from laparotomy to laparoscopy.

Qvigstad E, Lieng M - Obstet Gynecol Int (2011)

Mean age of women having laparoscopic and open abdominal procedures in 2002–2009.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3140043&req=5

fig3: Mean age of women having laparoscopic and open abdominal procedures in 2002–2009.
Mentions: In the early study period, women who were treated by laparoscopy had a lower BMI compared to women who underwent laparotomy. As illustrated in Figure 2, this has changed through the eight-year period, and women who had laparoscopic procedure in the last few years had higher BMI compared to the laparotomy group. Previously, advanced laparoscopic procedures were more unusual in older patients, and the average age of the included patients were almost 64 years. As observed for obesity, there has been a tendency with more laparoscopic procedures in older patients through the eight-year study period (Figure 3). A similar tendency was seen when preoperative histological diagnosis was examined in relation to the surgical approach. In 2002, all women with a high-risk preoperative histology (endometrioid adenocarcinoma with low tumour differentiation, clear cell, and serous papillary carcinoma) were treated by an open abdominal approach. Even though the laparoscopy procedures have varied among these patients through the years, a reasonable number of patients have experienced the benefits of minimally invasive surgery, and, in the last registered year (2009), two thirds of these patients had laparoscopic surgery.

Bottom Line: Laparoscopic hysterectomy has proved to be a safe alternative to open surgery in women with benign indications.Moreover, the laparoscopic technique was increasingly applied in older women, more obese women and in women with high-risk preoperative diagnosis, without increasing the complication rate.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology, Oslo University Hospital Ullevål and University of Oslo, 0407 Oslo, Norway.

ABSTRACT
Background. Laparoscopic hysterectomy has proved to be a safe alternative to open surgery in women with benign indications. Few studies compare laparotomy and laparoscopy in gynecologic oncology, and the objective of this study was to analyze the feasibility and development of laparoscopic surgery in endometrial cancer patients. Material and Methods. Records from all women having a hysterectomy due to premalignant or malignant endometrial changes during the years 2002-2009 were examined retrospectively. Results. A total of 521 hysterectomies were performed during the study period. Laparoscopy was performed in about 20% of the cases in the first two years, increasing to 83% in the last year of the period. Moreover, the laparoscopic technique was increasingly applied in older women, more obese women and in women with high-risk preoperative diagnosis, without increasing the complication rate. Conclusions. As for benign indications, laparoscopic hysterectomy in endometrial cancer patients should be preferred whenever possible.

No MeSH data available.


Related in: MedlinePlus