From July 2002 to December 2003, 33 patients (pts) affected by stage IIII endometrial adenocarcinoma were treated by LAVH, bilateral salpingo-oophorectomy (BSO) and laparoscopic pelvic lymphadenectomy (PL). These cases were compared with 33 hystorical controls undergoing TAH, BSO and PL. In the LAVH vs the TAH group, mean age was 60 vs 61, median BMI was 25 vs 27, median operative time (min) 210 (range 150—375) vs 190 (115—360) (p¼0.01), median blood loss (ml) 100 vs 300 (p<0.001), median hospitalisation 4 vs 7 days (p<0.001), transfusions 0 vs 6 pts (p¼0.02). Themedian number of nodes removed was not significantly different: 18 (11—44) in laparoscopy vs 18 (7—33) in laparotomy. Intraoperative complications (subcutaneousemphysema, bladder injury) were observed in 2 pts submitted to LAVH vs 0 submitted to TAH. Postoperative complications (fever, edema) occurred in 3 pts treated by LAVH and 6 treated by TAH(myocardial ischemia, lymphedema, UTI, ileus). In the LAVHgroup, 3 pts developed late complications (lymphocyst, lymphedema), compared to 11 pts in the TAHgroup (lymphedema, incisional hernia, lymphocyst, bowel obstruction) (p¼0.03), with the same incidence of lymphocyst. Median follow-up is 8 months for the LAVH cases, and 21 for the TAH control. LAVH is feasible in the majority of pts, with shorter hospitalization, less blood loss and requirement of blood transfusion, and lower rate of late complications. If a longer follow-up will confirm a similar disease-free survival in the two groups, LAVH and laparoscopic PL could be considered the treatment of choice in endometrial cancer.
Laparoscopic assisted vaginal hysterectomy (LAVH) versus total abdominal Hysterectomy (TAH) in endometrial cancer.
BERGAMINI, VALENTINO;GIUDICI, Silvia;FRANCHI, Massimo Piergiuseppe
2004-01-01
Abstract
From July 2002 to December 2003, 33 patients (pts) affected by stage IIII endometrial adenocarcinoma were treated by LAVH, bilateral salpingo-oophorectomy (BSO) and laparoscopic pelvic lymphadenectomy (PL). These cases were compared with 33 hystorical controls undergoing TAH, BSO and PL. In the LAVH vs the TAH group, mean age was 60 vs 61, median BMI was 25 vs 27, median operative time (min) 210 (range 150—375) vs 190 (115—360) (p¼0.01), median blood loss (ml) 100 vs 300 (p<0.001), median hospitalisation 4 vs 7 days (p<0.001), transfusions 0 vs 6 pts (p¼0.02). Themedian number of nodes removed was not significantly different: 18 (11—44) in laparoscopy vs 18 (7—33) in laparotomy. Intraoperative complications (subcutaneousemphysema, bladder injury) were observed in 2 pts submitted to LAVH vs 0 submitted to TAH. Postoperative complications (fever, edema) occurred in 3 pts treated by LAVH and 6 treated by TAH(myocardial ischemia, lymphedema, UTI, ileus). In the LAVHgroup, 3 pts developed late complications (lymphocyst, lymphedema), compared to 11 pts in the TAHgroup (lymphedema, incisional hernia, lymphocyst, bowel obstruction) (p¼0.03), with the same incidence of lymphocyst. Median follow-up is 8 months for the LAVH cases, and 21 for the TAH control. LAVH is feasible in the majority of pts, with shorter hospitalization, less blood loss and requirement of blood transfusion, and lower rate of late complications. If a longer follow-up will confirm a similar disease-free survival in the two groups, LAVH and laparoscopic PL could be considered the treatment of choice in endometrial cancer.
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