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Abstract Endometrial cancer is the most common gynecologic malignancy in developed countries. The standard approach for the staging and management of endometrial cancer is abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy, peritoneal washing, pelvic and para-aortic lymphadenectomy by open technique. However, the laparoscopic approach has recently been applied to women with endometrial cancer with excellent outcome and several investigators have demonstrated that total or vaginally assisted laparoscopic hysterectomy, associated with laparoscopic pelvic lymphadenectomy, represents a valid alternative to open surgery. Obese women are most likely to benefit from laparoscopic surgery as such surgery is associated with less post-operative pain, earlier ambulation, shorter hospital stays and fewer wound complications and pelvic abscess compared to open surgery. The aim of this study was to compare, in a series of women the feasibility, safety and morbidity of total laparoscopic hysterectomy (LPS) and abdominal hysterectomy with lymphadenectomy (LPT) for early-stage endometrial cancer. This was a prospective randomized trial of 50 patients allocated into two equal groups (25 patients in each), 25 patients in laparoscopic hysterectomy group (LPS group) and 25 patients in abdominal hysterectomy group (LPT group). Summary of our results • Age and BMI were insignificantly different between both groups. • Characteristics of the studied groups (Hb decline, blood loss and time of postoperative ileus) were significantly lower in the LPS group compared to LPT group. • Hospital stay and operative time were insignificantly different between the studied groups. • The incidence of fever was significantly lower in LPS group compared to LPT group. • Complications including (bladder injury, ureteric injury, conversion to laparotomy, missed intestinal injury, post-operative haematoma and wound infection) were insignificantly different between the studied groups. Conclusion In conclusion, laparoscopy is a suitable procedure for the treatment of patients with early endometrial cancer and may offer the potential benefits of decreased discomfort with decreased convalescence time, but it should be reserved for oncologic surgeons trained in extensive laparoscopic proce¬dures. Multi¬center randomized trials and long-term follow-up are required to evaluate the overall oncologic outcomes of this procedure, the recurrence rate, disease-free survival and the overall survival. |