The role of laparoscopic surgery in the management of endometrial cancer

Objective: To assess the place of laparoscopically assisted vaginal hystere ctomy in the treatment of endometrial cancer. Design: A retrospective uncontrolled case series. Setting: Gynaecological Oncology Department, Queen Elizabeth Hospital, Gate shead. Population: Women with endometrial cancer referred to this centre from Augu st 1992 to August 1997. Main outcome measures: Success of laparoscopically assisted vaginal hystere ctomy, operative morbidity, and the length of hospital stay. Results: Laparoscopically assisted vaginal hysterectomy was successful in 3 5 of 40 women (88%). Five women required laparotomy. Two women sustained in jury to the inferior epigastric vessels. One sustained injury to the small intestine requiring later laparotomy and three women required a blood trans fusion. The mean hospital stay was 3.3 days (SD 1.5). Three women died of t he disease within one year of their operation. Conclusion: Laparoscopically assisted vaginal hysterectomy is a feasible tr eatment for endometrial cancer. It can be performed successfully in high ri sk population who are medically unfit and overweight. However, a larger ran domised study is required to assess the morbidity compared with the traditi onal open approach.