Laparoscopic surgery of endometrial cancer. Preliminary results of a multicentric study

Objective To analyse the results of laparoscopic management of women with e ndometrial cancer, and comparison with the open technique. Design Prospective multicentre study. Setting Department of Gynaecology: Hospital for Infants, Kladno, Czech Repu blic. Subjects 76 women who underwent laparoscopic surgery and open procedures fo r endometrial cancer. Main outcome measures The differences between both the peri- and postoperat ive outcomes were evaluated. Results Two patients whose surgery was completed by laparotomy were exclude d from the study The other 43 laparoscopic procedures were successfully com pleted. Laparoscopic hysterectomy and pelvic and paraaortic lymphadenectomi es were carried out, based on the grade of the tumour and the depth of myom etrial invasion. Of the patients, 19 underwent pelvic lymphadenectomy and 1 4 women also had para-aortic lymph node sampling dissection. Five of these patients had positive pelvic or paraaortic nodes. The mean operating time w as 178 min vs. 151 min in the control open group. There were no major compl ications. Conclusions The laparoscopic approach to surgery for early stage endometria l carcinoma is an attractive alternative to the conventional surgical appro ach. The advantages of laparoscopic surgery are patient related. Because an abdominal incision is avoided, recovery time is reduced. The major obstacl e to incorporating operative laparoscopy into gynaecological oncology is th e lack of controlled studies demonstrating its ability to improve current m anagement.