Obstet Gynecol Sci.  2021 Jan;64(1):90-98. 10.5468/ogs.20216.

Comparison of single-port laparoscopy and laparotomy in early ovarian cancer surgical staging

• Cho KH
• Lee YJ
• Eoh KJ
• Lee YJ
• Lee JY
• Nam EJ
• Kim S
• Kim YT
• Kim SW

• KMID: 2511569
• DOI: http://doi.org/10.5468/ogs.20216

Abstract

Objectives
The aims of this study were to assess the feasibility of single-port laparoscopic surgical staging (SPLS) in early ovarian cancer and to compare the surgical outcomes of SPLS with those of staging laparotomy.
Methods
Between January 2014 and December 2018, 40 patients underwent SPLS and 41 patients underwent staging laparotomy at Yonsei Cancer Center. The patients were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I ovarian cancer. Variables such as patient age, body mass index (BMI), tumor size, FIGO stage, and perioperative surgical outcomes and survival outcomes of SPLS and laparotomy were compared.
Results
The total operation time was similar between the 2 groups (SPLS: 201.4 vs. laparotomy: 203.0 minutes, P=0.806). The median tumor diameters in the SPLS and laparotomy groups were 11.0 (2.5–28 cm) and 15.4 (6–40 cm), respectively (P=0.001). The SPLS group had lower tumor spillage rate (5.0% vs. 19.5%, P=0.047), less intraoperative blood loss (102.0 vs. 371.5 mL, P<0.001), less postoperative pain, and shorter postoperative hospital stay (5 vs. 9.5 days, P<0.001). The intraoperative major complication rate was similar between groups (2.5% vs. 4.9%, P=0.571). There was no significant difference in progression-free survival between the 2 groups (P=0.945). There were no deaths in either group.
Conclusion
SPLS is feasible in early ovarian cancer and has better perioperative surgical outcomes, in some aspects, than staging laparotomy without compromising survival outcomes. SPLS could be performed in patients suspected to have early ovarian cancer.

Keyword

Minimal invasive surgery; Laparoscopic surgery; Laparotomy; Cancer staging; Ovary

Figure

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  Fig. 1 Flowchart of patient selection. SPLS, single-port laparoscopic surgical staging; FIGO, International Federation of Gynecology and Obstetrics.

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  Fig. 2 Single-port laparoscopic surgical staging outside view (A) and safe tumor removal using a laparoscopic tissue retrieval bag (B, C).

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  Fig. 3 Comparison of survival curves between single-port laparoscopic surgical staging (SPLS) and staging laparotomy. (A) Before propensity score matching (SPLS, n=40 and staging laparotomy, n=41). (B) After propensity score matching (SPLS, n=21 and staging laparotomy, n=21).

Reference

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