Minimally invasive hysterectomy surgery rates for endometrial cancer performed at National Comprehensive Cancer Network (NCCN) Centers

Bergstrom, Jennifer; Aloisi, Alessia; Armbruster, Shannon D.; Yen, Ting Tai; Casarin, Jvan; Leitao, Mario M.; Tanner, Edward J.; Matsuno, Rayna K.; Machado, Karime Kalil; Dowdy, Sean C.; Soliman, Pamela T.; Wethington, Stephanie L.; Stone, Rebecca L.; Levinson, Kimberly; Fader, Amanda N.

doi:10.1016/j.ygyno.2018.01.002

Cited by 68 publications

(48 citation statements)

References 24 publications

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“…7 8 11 14-16 Bergstrom et al evaluated the rates of minimally invasive surgery for endometrial cancer at high-volume National Comprehensive Cancer Network centers and concluded that disparities in age, race, and body mass index seen in studies based on national databases were not observed at these centers, and the rates of minimally invasive surgery at these centers were higher than the national average, all while having low perioperative complications. 14 In the landmark LAP2 study, Walker et al demonstrated the safety and feasibility of minimally invasive surgery in endometrial cancer, without compromise to oncologic outcomes in these patients. 7 8 These patients had less postoperative pain, shorter recovery periods, and shorter length of hospital stay, without an increase in rates of complications, intraoperative injuries, or compromise to survival.…”

Section: Discussionmentioning

confidence: 99%

Comparison of minimally invasive versus open surgery in the treatment of endometrial carcinosarcoma

Nobre

Mueller

Gardner

et al. 2020

Int J Gynecol Cancer

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ObjectiveThe aim of this study was to compare perioperative and oncologic outcomes between minimally invasive and open surgery in the treatment of endometrial carcinosarcoma.MethodsWe retrospectively identified all patients with newly diagnosed endometrial carcinosarcoma who underwent primary surgery via any approach at our institution from January 2009 to January 2018. Patients with known bulky disease identified on preoperative imaging were excluded. The χ2 and Mann–Whitney U tests were used to compare categorical and continuous variables, respectively. Kaplan–Meier curves were used to estimate survival, and compared using the log rank test.ResultsWe identified 147 eligible patients, of whom 37 (25%) underwent an open approach and 110 (75%) underwent minimally invasive surgery. Within the minimally invasive group, 92 (84%) of 110 patients underwent a robotic procedure and 14 (13%) underwent a laparoscopic procedure. Four minimally invasive cases (4%) were converted to open procedures. Median age, body mass index, operative time, stage, complication grade, and use of adjuvant treatment were clinically and statistically similar between groups. Median length of hospital stay in the open group was 4 days (range 3–21) compared with 1 day (range 0–6) in the minimally invasive group (p<0.001). The rates of any 30-day complication were 46% in the open and 8% in the minimally invasive group (p<0.001). The rates of grade 3 or higher complications were 5.4% and 1.8%, respectively (p=0.53). Median follow-up for the entire cohort was 30 months (range 0.4–121). Two-year progression-free survival rates were 52.8% (SE±8.4) in the open group and 58.5% (SE±5.1) in the minimally invasive group (p=0.7). Two-year disease-specific survival rates were 66.1% (SE±8.0) and 81.4% (SE±4.1), respectively (p=0.8).ConclusionsIn patients with clinical stage I endometrial carcinosarcoma, minimally invasive compared with open surgery was not associated with poor oncologic outcomes, but with a shorter length of hospital stay and a lower rate of overall complications.

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Section: Discussionmentioning

confidence: 99%

Comparison of minimally invasive versus open surgery in the treatment of endometrial carcinosarcoma

Nobre

Mueller

Gardner

et al. 2020

Int J Gynecol Cancer

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“…These rates are characterized by low perioperative complications with higher weight/BMI as barriers to performance. A proposed MIS hysterectomy benchmark of >80 % in endometrial cancer care is feasible when performed at high-volume centers with gynecologic oncologists [6].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical cytoreduction remains paramount in the treatment of early-stage and advanced endometrial cancer. MIS was approved as a quality measure by the Society of Gynecologic Oncology (SGO) in 2014 and incorporated into the National Comprehensive Cancer Network's (NCCN) guidelines in 2017 [6,7]. Globally, a recent U.S. Centers for Disease Control (CDC) study demonstrated that endometrial cancer rates increased in 26 of the 43 countries, with South Africa and several countries in Asia showing the largest increase [8].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgical access in morbidly obese women undergoing endometrial cancer surgery: Repurposing the left upper quadrant approach

Varghese

Peijnenburg²,

Stone³

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The minimally invasive can be performed to endometrial cancer safely with the utilization of the retrieval bag through a vagina to limit tissue fragmentation within a packet. 3 This case was selected for the closed-entry procedure with general Veress needle technique; the two attempts were successful for VN insertion followed by the creation of pneumoperitoneum at a pressure of 15 mm Hg, the VN was removed. There is no accepted universal definition of failed closed-entry.…”

Section: Discussionmentioning

confidence: 99%

An Extensive Extraperitoneal Insufflation due to Veress Needle Associated Complication

Wasinghon¹

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim:The case report presented of the uncommon extensive extraperitoneal insufflation due to Veress needle (VN) procedure of laparoscopy. Background:The minimally invasive surgery has become the method of choice for the most benign disease. Creation of pneumoperitoneum is the first step of a laparoscopy. The Veress needle is placed blindly into the abdomen. There are major and minor complications of laparoscopy. The purpose of this study was to expose the minor complication outcome of extraperitoneal insufflation with VN access. The complication of this operation occurred during the laparoscopic surgical staging of endometrial cancer. Case description:A 61-year-old woman, para two of vaginal deliveries, had previous laparoscopic Gilliam uterine suspension owing to uterine prolapse. She had menorrhagia for 6 months after her menopausal age of 53 years. The uterine had undergone curettage, and the histopathology displayed endometrial carcinoma. The treatment was laparoscopic surgical staging. While the VN was inserted and CO 2 insufflation was taking place with 15 mm Hg, a minor intraoperative complication had occurred. The laparoscopy revealed Gilliam uterine suspension (GUS) where the extraperitoneal emphysema had occurred. The extraperitoneal emphysema was released with a needle gauge No.18 exteriorly during surgery. Conclusion:The extensive extraperitoneal insufflation image shows a minor complication that is very uncommon reviewed and can thus be educational for the endoscopist.Clinical significance: The VN was inserted vertically following the creation of pneumoperitoneum at a pressure of 10 to15 mm Hg, the Veress needle was removed. Then a 10 mm disposable shielded trocar was introduced in the pelvic cavity.

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Minimally invasive hysterectomy surgery rates for endometrial cancer performed at National Comprehensive Cancer Network (NCCN) Centers

Cited by 68 publications

References 24 publications

Comparison of minimally invasive versus open surgery in the treatment of endometrial carcinosarcoma

Comparison of minimally invasive versus open surgery in the treatment of endometrial carcinosarcoma

Laparoscopic surgical access in morbidly obese women undergoing endometrial cancer surgery: Repurposing the left upper quadrant approach

An Extensive Extraperitoneal Insufflation due to Veress Needle Associated Complication

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