Analysis of Failed and Complicated Laparoscopy on a Gynecologic Oncology Service

Eltabbakh, Gamal H.; Piver, M. Steven; Hempling, Ronald E.; Recio, Fernando O.; Paczos, Tamera

doi:10.1006/gyno.1999.5511

Cited by 18 publications

(6 citation statements)

References 8 publications

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“…Thus we anticipate that the reduction in hospital stay is not only due to changed discharge habits during a certain period. This is in contrast to other studies where the TAH group was in the past and the LAVH group represented recent practice (15).…”

Section: Discussioncontrasting

confidence: 74%

“…The mean weight of the patients was 68.8 kg for the LAVH group, and 73.1 kg for the TAH group. Eltabakh et al (15) recently found that most obese women with early‐stage endometrial cancer can be safely managed by laparoscopy. In the current study the BMI values for the LAVH and TAH groups were 25.5 and 26.6, respectively, with fewer complications in the LAVH group.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic‐assisted vaginal vs. abdominal surgery in patients with endometrial cancer stage 1

Tollund

Hansen

Kjer

2006

Acta Obstet Gynecol Scand

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Laparoscopic‐assisted vaginal vs. abdominal surgery in patients with endometrial cancer stage 1

Tollund

Hansen

Kjer

2006

Acta Obstet Gynecol Scand

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“…Conversions to laparotomy were associated with significantly greater blood loss than successful TLH [23]. The estimated blood loss was greater in patients of conversion to laparotomy (455.6 ± 143.7 ml) than in patients of successful TLH (304.2 ± 45.8 ml) during operation in our study.…”

Section: Discussionmentioning

confidence: 46%

Factors Determining Conversion to Laparotomy in Patients Undergoing Total Laparoscopic Hysterectomy

Park

Cho

Kim³

2010

Gynecol Obstet Invest

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Aims: To identify the risk factors determining conversion to laparotomy during total laparoscopic hysterectomy (TLH) for benign diseases. Methods: We retrospectively reviewed medical records of 288 patients that underwent TLH during the first 2 years of performing TLH at Kang-Nam Sacred Heart Hospital. Twenty-three cases were converted to laparotomy. We compared patient characteristics, indications for hysterectomy, operation time, estimated blood loss, adhesion, uterine weight and postoperative complications between failed and successful groups. Results: The rate of conversion to laparotomy was 8%. There were no differences in patient characteristics between the two groups. Independent risk factors for conversion were adhesion and uterine weight. The most common cause of the conversion to laparotomy was adhesions (p = 0.000). Uterine weight was found to be heavier in the failed group (331.5 ± 157.1 vs. 270.3 ± 132.5 g, p = 0.038). Estimated blood loss was greater in the failed group (455.6 ± 143.7 vs. 304.2 ± 45.8 ml, p = 0.047). Bladder injury occurred in the failed group more frequently than in the successful group (p = 0.024). Conclusion: An awareness of risk factors for conversion is important for better patient selection for TLH. Indirect measurement of uterine weight by sonography and detailed history taking is helpful in determining the appropriate hysterectomy route.

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“…There was no significant difference in the incidence rate or degree of adhesions between women who underwent LAVH and those who underwent TAH. In a review of 204 consecutive surgical laparoscopies performed in women attending a gynecologic oncology clinic, adhesions were found to be the only significant independent risk factor that was predictive of failed or complicated laparoscopy 14…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma

Eltabbakh

Shamonki

Moody

et al. 2001

Cancer

Self Cite

167

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BACKGROUND The current study was conducted to assess the feasibility of laparoscopy in the treatment of women with early stage endometrial carcinoma and to compare the surgical outcome, cost, and quality of life among these patients with those treated with laparotomy. METHODS A prospective study was conducted over 2 years in which all women with early stage endometrial carcinoma who could tolerate laparoscopic surgery were treated with laparoscopically assisted vaginal hysterectomy (LAVH), bilateral salpingo‐oophorectomy (BSO), and lymphadenectomy. Women with a similar disease stage who underwent similar surgical procedures through laparotomy in the previous 2 years were used as the control group. Both groups were compared with regard to their characteristics, surgical outcome, and cost and were interviewed regarding their quality of life. RESULTS Eighty‐six of 90 women with endometrial carcinoma underwent LAVH. The procedure was converted to laparotomy in 5 patients (5.8%). Laparoscopic surgery thus was successful in 90% of the women. There were no significant differences noted between those women who underwent LAVH and those who underwent total abdominal hysterectomy (TAH) (n = 57) with regard to patient characteristics, type of surgical procedure, preoperative and postoperative hematocrit, complications, patient recall of postoperative pain, and tumor recurrence. LAVH patients had significantly smaller body mass indices, a longer surgical time, more pelvic lymph nodes, a smaller decrease in postoperative hematocrit, received less pain medication, had a shorter hospital stay, an earlier return to full activity and work, and a higher level of satisfaction with their treatment, although their procedures had a higher cost compared with TAH patients. CONCLUSIONS The majority of women with early stage endometrial carcinoma can be treated with laparoscopy with an excellent surgical outcome, shorter hospitalization, earlier recovery, and improved quality of life, but with a higher financial cost. Cancer 2001;91:378–87. © 2001 American Cancer Society.

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Analysis of Failed and Complicated Laparoscopy on a Gynecologic Oncology Service

Cited by 18 publications

References 8 publications

Laparoscopic‐assisted vaginal vs. abdominal surgery in patients with endometrial cancer stage 1

Laparoscopic‐assisted vaginal vs. abdominal surgery in patients with endometrial cancer stage 1

Factors Determining Conversion to Laparotomy in Patients Undergoing Total Laparoscopic Hysterectomy

Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma

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