Surgical management of endometrial adenocarcinoma using laparoscopically assisted staging and treatment

Background. Because of inaccuracies in clinical staging, endometrial adenoc arcinoma is now a surgically staged disease. This study was done to determi ne the safety and efficacy of a laparoscopically assisted approach in the t reatment and staging of this disease. Methods. Using a retrospective chart review, we identified demographic char acteristics, mean blood loss, operative findings, and complications of pati ents who had laparoscopically assisted staging and treatment for endometria l carcinoma from 1992 to 1997. Results. Of 34 patients, 28 had laparoscopic surgical staging that included pelvic and paraaortic lymph node assessment, peritoneal washings, bilatera l salpingo-oophorectomy, and total vaginal hysterectomy; 23 patients (82%) had stage I disease, 2 (7%) had stage II disease, and 3 (11%) had stage III disease. Complications included herniation through a 5 mm port site, neces sitating small bowel resection, and a fatal myocardial infarction 10 days p ostoperatively. Conclusion. Laparoscopic staging and treatment of endometrial carcinoma is appropriate in a select group of patients.