Total Laparoscopic Hysterectomy Versus Abdominal Hysterectomy With Lymphadenectomy for Early-Stage Endometrial Cancer: A Prospective Randomized Study

Malzoni, Mario; Tinelli, Andrea; Cosentino, Francesco; Perone, Ciro; Rasile, Marianna; Iuzzolino, Domenico; Malzoni, Carmine; Reich, Harry

doi:10.1097/01.ogx.0000345725.70377.f6

Cited by 11 publications

(19 citation statements)

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“…The sample size in each trial was relatively small, ranging from 52 to 332 participants. The quality of randomized controlled trials was assessed by the Jadad's score, and 5 trials were high quality randomized controlled trials with scores no less than 3 points (Tozzi et al, 2005;Malzoni et al, 2009;Zullo et al, 2009;Janda et al, 2010;Mourits et al, 2010). Table 1 summarized the main results of this metaanalysis.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Six studies were further excluded including one study for no available data (Nicklin et al, 2011) and 5 overlapping studies (Tozzi et al, 2005;Zullo et al, 2005;Bijen et al, 2009;. Finally, nine randomized controlled trials with a total of 1263 patients were included into this meta-analysis (Fram, 2002;Tozzi et al, 2005;Zorlu et al, 2005;Chen and Huang, 2007;Wang, 2008;Malzoni et al, 2009;Zullo et al, 2009;Janda et al, 2010;Mourits et al, 2010). The sample size in each trial was relatively small, ranging from 52 to 332 participants.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Wang

Ren²,

Yang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while total laparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This metaanalysis was performed to investigate the effects of TLH versus TAH in women with early-stage endometrial cancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trials assessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR) with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomized trials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lower

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Wang

Ren²,

Yang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…[1][2][3] In most institutions, laparoscopic removal of the uterus requires the use of a balloon tip intrauterine manipulator, which is inflated with saline throughout the procedure. There has been controversy in the past years as to whether laparoscopic hysterectomies are associated with higher rates of positive peritoneal washings, presumably related to the increased intrauterine pressure from the manipulator causing tumor cells to be propelled through the fallopian tubes into the peritoneal cavity.…”

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confidence: 99%

Evaluation of vascular space involvement in endometrial adenocarcinomas: laparoscopic vs abdominal hysterectomies

et al. 2010

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Recent reports have described 'vascular pseudoinvasion' in total laparoscopic hysterectomies with endometrial carcinoma. To better understand this phenomenon, we compared pathologic findings in these laparoscopic and total abdominal hysterectomies performed for uterine endometrioid adenocarcinoma. Reports from 58 robotically assisted laparoscopic and 39 abdominal hysterectomies with grade 1 or 2 endometrioid endometrial adenocarcinomas were reviewed for stage, depth of invasion, vascular space involvement, uterine weight, and lymph node metastases. In addition, attention was given to possible procedural artifacts, including vertical endomyometrial clefts, and inflammatory debris, benign endometrial glands, and disaggregated tumor cells in vascular spaces. All foci with vascular involvement were reviewed by three gynecologic pathologists. Nine of the 58 (16%) laparoscopic and 3 of the 39 (7%) abdominal hysterectomies contained vascular space involvement based on the original pathology reports (P-value ¼ 0.0833). No one histologic feature consistently distinguished laparoscopic from abdominal cases on blind review of the available cases. Disaggregated intravascular tumor cells were significantly associated with reported vascular involvement in both procedures (P-valueso0.001 and 0.016), most of which were corroborated on review. Laparoscopic procedures tend to have a higher index of vascular involvement, which is associated with lower stage, fewer lymph node metastases, and less myometrial invasion; however, pathologists cannot consistently determine the procedure on histologic findings alone. Moreover, there is significant inter-observer variability in distinguishing true from artifactual vascular space involvement, even among pathologists at the same institution. The clinical significance of apparent true vascular space involvement seen adjacent to artifacts is unclear, as is the impact of laparoscopic hysterectomy on recurrence risk.

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“…Numerous investigators demonstrated that laparoscopic approach in performing radical hysterectomy or endometrial cancer staging operation was not only feasible, but also achievable. [29][30][31][32][33] However, a recent survey investigating the use of MIS by the Society of Gynecologic Oncology (SGO) members showed that only 26% of SGO members considered laparoscopic radical hysterectomy as an appropriate approach to the management of cervical cancer. 34 The Korean Gynecologic Oncology Group (KGOG) Survey also revealed that only 49% of KGOG members used laparoscopy for endometrial cancer staging surgery.…”

Section: Robot Assisted Laparoscopic Surgery In Gynecologic Cancermentioning

confidence: 99%

Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology

Jung

Kim

2009

J Gynecol Oncol

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Two innovative approaches in minimally invasive surgery that have been introduced recently are the da Vinci robotic platform and single port laparoscopic surgery (SPLS). Robotic surgery has many advantages such as 3-dimensional view, the wrist like motion of the robotic arm and ergonomically comfortable position for the surgeon. Numerous literatures have demonstrated the feasibility of robotic surgery in gynecologic oncology. However, further research should be performed to demonstrate the superiority of robotic surgery compared to conventional laparoscopy. Additionally, cost reduction of robotic surgery is needed to adopt robotic surgery into gynecologic oncology worldwide. SPLS has several possible benefits including reduced operative complications, reduced postoperative pain, and better cosmetic results compared to conventional laparoscopy. Although several authors have indicated that SPLS is a feasible approach for gynecologic surgery, there have been few reports demonstrating the potential advantages over conventional laparoscopy. Moreover, technical difficulties of SPLS still exist. Therefore, the advantages of a single port approach compared to conventional laparoscope should be evaluated with comparative study, and further technologic development for SPLS is also needed. These two progressive technologies take the lead in the development of MIS and further studies should be performed to evaluate the benefits of robot surgery and SPLS.

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Total Laparoscopic Hysterectomy Versus Abdominal Hysterectomy With Lymphadenectomy for Early-Stage Endometrial Cancer: A Prospective Randomized Study

Cited by 11 publications

References 0 publications

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy for Endometrial Cancer: A Meta-analysis

Evaluation of vascular space involvement in endometrial adenocarcinomas: laparoscopic vs abdominal hysterectomies

Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology

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