Comparison of the laparoscopic versus conventional open method for surgical staging of endometrial carcinoma

Chu, Ling-Hui; Chang, Wen‐Chun; Sheu, Bor‐Ching

doi:10.1016/j.tjog.2016.02.007

Cited by 33 publications

(19 citation statements)

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“…Most of the studies reported lower blood loss in the laparoscopy group (9,(12)(13)(14). In our study, the difference between pre-operative and post-operative hemoglobin values was higher in the laparotomy group and was similar to published data.…”

Section: Discussionsupporting

confidence: 91%

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Perioperative and postoperative outcomes of laparoscopy and open method for surgical staging of endometrial cancer

Vatansever

Giray

Aboalhasan

2019

Zeynep Kamil Tıp Bülteni

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Objective: The aim of the study was to compare the safety of the laparoscopic and open method for endometrial cancer staging. Material and Methods: Between January 2015 and August 2017, we reviewed 121 women with endometrial cancer treated by open (n=81) or laparoscopic (n=40) approach, retrospectively. Two groups were compared in terms of operating times, intraoperative and postoperative complications, perioperative and postoperative features such as hemoglobin values, the lengths of hospital stay, and adjuvant therapy. All of the patients underwent a hysterectomy and bilateral salpingo-oophorectomy; and when indicated, omentectomy and lymphadenectomy were performed. Results: There were no significant differences between the two groups with regard to the number of parities, body mass index, menopausal status, age, the American Society of Anesthesiologists (ASA) scores, the requirement of lymphadenectomy, and hospital stay. There were significant statistical differences between groups in terms of operation time and difference of hemoglobin (p<0.001, p=0.013; respectively). Laparoscopic surgery had a longer operative time than laparotomy, and difference of hemoglobin in the laparotomy group is more than the laparoscopy group. Patients who underwent staging with laparotomy had bowel injury (1.2%), wound infection (13.6%), and postop ileus (8.6%) while in the laparoscopy group patients had wound infection (2.5%) and postop ileus (5%). There were no statistically significant differences between the two groups in terms of the intraoperative (p=1) and postoperative complications (p=0.101 for wound infection, p=0.716 for postop ileus). The groups were similar in terms of the histological grade, FIGO stage, histologic subtype, the rate of lymphovascular invasion, the depth of myometrial invasion, the total number of lymph nodes resected in lymph node dissections, the rate of lymph node metastasis, the location of the tumor, cervical stromal invasion, and the adjuvant therapy such as chemotherapy and brachytherapy. None of the patients in both groups had a recurrence and long-term lymphatic complication such as lymphocyst, lymphedema. Conclusion: Our current data demonstrated that the laparoscopic approach can be performed without loss of safety with similar complication rates in patients with endometrium cancer. Additionally, the laparoscopy was not inferior to the laparotomy in terms of efficacy.

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Section: Discussionsupporting

confidence: 91%

“…Most of the previous studies reported significantly shorter hospital stays with laparoscopy (9,13,24). We found that both groups were similar in terms of hospitalization.…”

Section: Discussionsupporting

confidence: 65%

Perioperative and postoperative outcomes of laparoscopy and open method for surgical staging of endometrial cancer

Vatansever

Giray

Aboalhasan

2019

Zeynep Kamil Tıp Bülteni

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“… 4 5 The survival outcome of cancer patients obtained through laparoscopy is not inferior to that obtained through laparotomy. 6 7 To provide an international standard of surgical care for female cancers, the gynecologic cancer team of Tzu Chi General Hospital initiated laparoscopic staging surgery in 2010 and laparoscopic radical hysterectomy in 2011. Since then, the proportion of laparoscopic gynecologic cancer surgery rapidly increased annually and reached 100% in 2016.…”

Section: Silent Mentor Program Improves Our Surgical Level and Patienmentioning

confidence: 99%

How the silent mentor program improves our surgical level and safety and nourishes our spiritual life

Hong

Chu

Ding

2017

Gynecology and Minimally Invasive Therapy

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We briefly share our experience of using the silent mentor program in the Medical Simulation Center (MSC) of Tzu Chi University (TCU), Hualien, Taiwan, to improve our minimally invasive surgical level and patient’s safety. The silent mentor program, established in 2000 by the Department of Anatomy of TCU, is a pioneering clinical skill training program based on unembalmed bodies. This program provides three valuable advantages for surgery. The first is the comprehensive understanding of the deep or rarely observed but crucial structures of the human body, which is normally difficult to achieve in living humans. The second is gaining the first experience of a novel procedure or surgery on silent mentors rather than on living humans, which is essential for young surgeons to begin their careers. The third is evaluating the safety and feasibility of a novel surgical method. In addition to surgical techniques, the most valuable point of the program is the humane ceremonies conducted for silent mentors to nourish our soul. After the workshop, all the incision wounds on every silent mentor were carefully checked and sutured in the same manner as in closing surgical wounds in a patient. Subsequently, encoffining, cremation, and thanksgiving ceremonies were solemnly held, in the hope that the medical students or trainees would imperceptibly understand their responsibility to society and the silent mentor’s expectations. The Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy, or the Taiwan Association for Minimally Gynecology Therapy, or both can consider initiating a regular silent mentor program in the MSC of TCU. It is not only intended to improve the skills of surgeons but also to allow them to participate in the interactive ceremony and thus refresh their humanitarian knowledge.

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“…Previous research comparing the OS with the LS [6] and the LS with the RS exists [7], along with one meta-analysis comparing all three approaches [8]. However, data are scarce concerning the direct comparison of survival outcomes among the OS, the LS, and the RS for endometrial cancer [9].…”

Section: Introductionmentioning

confidence: 99%

Nationwide Comparison of Surgical and Oncologic Outcomes in Endometrial Cancer Patients Undergoing Robotic, Laparoscopic, and Open Surgery: A Population-Based Cohort Study

et al. 2021

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Population-based comparisons between minimally invasive surgery (MIS) (robotic surgery [RS] and laparoscopic surgery [LS]) and open surgery (OS) for managing endometrial cancer are lacking. This study aimed to compare surgical and oncologic outcomes between endometrial cancer patients who underwent surgical staging via MIS or OS. Materials and Methods A population-based retrospective cohort study was performed using claims data from the Korean National Health Insurance database from January 2012 to December 2016. All patients who underwent hysterectomy under diagnosis of endometrial cancer were identified. Patients were classified into RS, LS, and OS groups. Operative and oncologic outcomes were compared among the three groups after adjustments for age group, risk group (adjuvant therapy status), modified Charlson comorbidity index, income level, insurance type, and index year using propensity scores obtained via the inverse probability of treatment weighted method. Results After adjustment, 5,065 patients (RS, n=315; LS, n=3,248; OS, n=1,503) were analyzed. Patient demographics were comparable. Hospital stay, postoperative complications, and cost were more favorable in the RS and LS groups than in the OS group (all p < 0.001). Five-year overall survival was significantly longer in the RS and LS groups than in the OS group (94.8%, 91.9%, and 86.9%, respectively; p < 0.001). Moreover, the survival benefit of RS was shown in the subgroup analysis of low-risk endometrial cancer patients. Conclusion Our study provides further evidence for the RS being a safe surgical alternative to the LS and OS, especially in low-risk endometrial cancer patients, offering surgical and oncologic outcomes equivalent to other surgical approaches.

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Comparison of the laparoscopic versus conventional open method for surgical staging of endometrial carcinoma

Abstract: Our preliminary results showed that the laparoscopic method for staging endometrial cancer was technically feasible and efficient.

Cited by 33 publications

References 50 publications

Perioperative and postoperative outcomes of laparoscopy and open method for surgical staging of endometrial cancer

Perioperative and postoperative outcomes of laparoscopy and open method for surgical staging of endometrial cancer

How the silent mentor program improves our surgical level and safety and nourishes our spiritual life

Nationwide Comparison of Surgical and Oncologic Outcomes in Endometrial Cancer Patients Undergoing Robotic, Laparoscopic, and Open Surgery: A Population-Based Cohort Study

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