Luigi Frigerio

In coll.  Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi M
Int J Gynaecol Obstet. 2006 Mar 6;
OBJECTIVE: To see whether laparoscopy provides exact staging and effective treatment of endometrial cancer patients, compared with total abdominal hysterectomy, with shorter hospital stay, prompter recovery, and better quality of life. METHOD: This retrospective study identified 110 patients scheduled for surgery for early-stage endometrial cancer. Fifty-five (50%) were treated by laparoscopic-assisted vaginal hysterectomy (LAVH) and 55 (50%) by total abdominal hysterectomy (TAH). All patients underwent pelvic lymphadenectomy. The majority of patients (79%) had stage I disease. RESULTS: The mean number of lymph nodes removed was 17 for the LAVH group and 18.5 for the TAH group (p=0.294). Compared with TAH, LAVH required a significantly longer operating time (220 vs. 175min; p<0.01); but shorter hospital stay (4 vs. 8.5days; p<0.001) and less estimated blood loss (177cm(3) vs. 285cm(3); p=0.02). Overall, there were fewer post-operative complications in the LAVH group (6 vs. 11 cases; p<0.001). Three TAH patients (5.4%) had recurrence of disease. No LAVH patients had recurrences and all are currently disease-free. CONCLUSION: These findings suggest LAVH gives correct staging of endometrial disease, like TAH, but with fewer complications and a slightly longer operating time.