Comparisons of Surgical Outcomes, Complications, and Costs Between Laparotomy and Laparoscopy in Early-Stage Ovarian Cancer

Lee, Maria; Kim, Sang Wun; Paek, Jiheum; Lee, San Hui; Yim, Ga Won; Kim, Jae Hoon; Kim, Jae Wook; Kim, Young Tae; Nam, Eun Ji

doi:10.1097/igc.0b013e318208c71c

Cited by 70 publications

(78 citation statements)

References 22 publications

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“…Furthermore, the risk of recurrence is even lower, approximately 2.5-5.7%, when complete surgical staging is completed [24]. Complete staging, however, is associated with more complications [9,10]. Intraoperatively there is an increased risk of nerve, vascular, bowel, urinary and lymphatic complications.…”

Section: Discussionmentioning

confidence: 99%

“…In other clinical scenarios, including but not limited to fertility preservation, clinicians may perform any of the aforementioned procedures in any combination [3,14] either through laparotomy or laparoscopy [15,16]. In terms of surgical outcomes, laparotomy is associated with more complications than laparoscopy [9,10]. However, laparoscopy is associated with a higher risk of recurrence, port site metastasis and improper staging [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Aggressive surgical management increases morbidity [9,10]. In the case of BOTs specifically, complete surgical staging increases operating time, blood loss, the risk of blood transfusion, the length of hospital stay and the overall complication rate including wound complications, lymphocele, postoperative ileus and bowel injury [11].…”

Section: Introductionmentioning

confidence: 99%

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Management of Borderline Ovarian Tumors Based on Patient and Tumor Characteristics

Black

Altwerger²,

Ratner³

et al. 2015

Gynecol Obstet Invest

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Background: Borderline ovarian tumors are staged similarly to invasive ovarian tumors. Aims: We wanted to better understand which tumors were associated with disease recurrence. Methods: We performed a retrospective cohort analysis at a single institution between 1984 and 2005. Cases were confirmed by pathology report. Multivariate analysis was done to evaluate factors associated with recurrence. Results: 143 cases were identified. Mean follow-up was 73.5 months. The overall risk of recurrence was 12%. The hazard ratio for risk of recurrence was highest among seromucinous tumors at 4.04 and lowest among mucinous tumors at 0.53. Only 4% of mucinous tumors, 15.5% of serous tumors and 28.6% of seromucinous tumors recurred. 2% of mucinous tumors had an appendix positive for metastasis. No mucinous tumor had nodal disease. Conclusions: Based on our data, a low rate of appendiceal or lymph node involvement was observed in mucinous tumors, as was a low risk of recurrence. Less aggressive staging may be considered if a mucinous tumor is identified on frozen section with a normal-appearing appendix in the absence of pseudomyxoma peritonei. In patients with a serous or a seromucinous tumor, complete surgical staging is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of Borderline Ovarian Tumors Based on Patient and Tumor Characteristics

Black

Altwerger²,

Ratner³

et al. 2015

Gynecol Obstet Invest

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“…Women with advanced ovarian cancer have a 5-year survival rate of <50%, but those with Stage I ovarian cancer have a 5-year survival rate of 85e90% [3]. However, in clinical practice, Stage I ovarian cancer is usually found incidentally during routine ultrasonography, laparoscopy, or laparotomy for an ovarian cyst or presumed benign tumors [4,5]. Furthermore, for patients with Stage I ovarian cancer, >30% are upstaged after comprehensive surgical staging because of microscopic metastatic disease [2,6].…”

Section: Introductionmentioning

confidence: 98%

Systematic review of laparoscopic comprehensive staging surgery in early stage ovarian cancer: A meta-analysis

Lü

Yao

2015

Taiwanese Journal of Obstetrics and Gynecology

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“…There is sufficient evidence that minimally invasive surgery can reduce perioperative blood loss, blood transfusions, postoperative pain, complications, recovery time, and hospital stay [1]- [5]. However, despite the documented benefits of the minimally invasive approach in patients, due to the steep learning curve, and technical difficulties, this has been slow to gain acceptance [6].…”

Section: Introductionmentioning

confidence: 99%

Impact of Age on Surgical Outcomes after Robot Assisted Laparoscopic Hysterectomies

Eddib¹,

Hughes²,

Aalto³

et al. 2014

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Objective: To estimate the impact of patient's age on surgical outcomes in patients undergoing robotic hysterectomy. Methods: A retrospective review of prospectively collected cohort data for a consecutive series of patients undergoing gynecologic robotic surgery. Patient's age and perioperative variables were collected from the database, charts, and other hospital records of all patients undergoing robotic hysterectomy. Results: 399 patients underwent robotic surgery for gynecologic disease. 370 patients who were under age 70 were compared with 29 patients who were over age 70. When comparing all patients under age 70 with patients over age 70, the mean age was 48.4 and 77 (P < 0.05), mean BMI was 32.1 and 28.3 kg/m 2 (P < 0.05), mean procedure time was 185 and 211 minutes (min) (P = 0.09), mean console time was 123 and 148 min (P = 0.056), mean OR (Operating room) time was 237 and 273, mean EBL (Estimated blood loss) was 71 and 65 ml (P = 0.74), Hb (Hemoglobin) drop was 1.4 and 1.2 (P = 0.45), uterine weight was 212 and 95 gm (P = 0.98), and length of stay was 1.4 and 1.6 days (P = 0.33) ( Table 1). The patients over age 70, when procedures were combined, had a statistically significant lower mean BMI, uterine weight and longer Operating room (OR) time. However, when stratified by the type of procedure performed, there was no difference in surgery times among those under 70 and over 70 years of age. The elderly patients were more likely to have cancer, which was in almost half the elderly patients, and thus necessitate staging. Thus adding the performance of lymph node dissection likely resulted in the increased length of the surgery time that was noted in the combined group (Tables 1, 2). There were no operative deaths. Conclusions: Advanced age does not appear to be associated with an increased risk of morbidity, or adverse perioperative outcomes in patients undergoing robotic hysterectomy.

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Comparisons of Surgical Outcomes, Complications, and Costs Between Laparotomy and Laparoscopy in Early-Stage Ovarian Cancer

Cited by 70 publications

References 22 publications

Management of Borderline Ovarian Tumors Based on Patient and Tumor Characteristics

Management of Borderline Ovarian Tumors Based on Patient and Tumor Characteristics

Systematic review of laparoscopic comprehensive staging surgery in early stage ovarian cancer: A meta-analysis

Impact of Age on Surgical Outcomes after Robot Assisted Laparoscopic Hysterectomies

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