Laparoscopically-assisted Vaginal Hysterectomy Versus Abdominal Hysterectomy in Patients with Endometrial Cancer

Kim, Jong Hyeok; Lee, Sang Soo; Kim, Dae Yeon; Jin, Tian Fu; Kim, Yong Man; Kim, Young Tak; Mok, Jung Eun; Nam, Joo Hyun

Abstract

OBJECTIVE
To evaluate the outcomes of laparoscopic surgery and to compare surgical parameters and recurrence rate of these with those of conventional abdominal surgery in patients with endometrial cancer.
METHODS
From August 1997 to November 2003, we have performed 79 cases of LAVH (laparoscopically assisted vaginal hysterectomy) with or without lymph node dissection. Laparoscopic approach was adapted in patients with FIGO clinical stage I by imaging study. Of the 79 patients, 74 patients who were proved to be surgical stage I and II were enrolled in this comparative study. As a control group, we selected 168 cases for the laparotomy group of the same stages.
RESULTS
The mean duration of surgery, the amount of blood transfusion and hemoglobin changes were similar in both the laparoscopy and the conventional laparotomy group. The mean duration of hospital stay was significantly shorter in patients treated by laparoscopic surgery (10.2 vs. 15.5 days). The number of lymph node obtained was significantly higher in the laparoscopy group. Two year recurrence-free survival rates were 97.5% in laparoscopy group and 98.6% in laparotomy group (p=0.763).
CONCLUSION
Laparoscopic surgery for the treatment of early stage endometrial cancer is safe and effective alternatives in terms of perioperative complications. Overall and recurrence-free survival did not differ significantly in both groups however long term risk for recurrence and survival has yet to be defined.