Safety of total laparoscopic modified radical hysterectomy with or without lymphadenectomy for endometrial cancer

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• 作者：Masakazu Kitagawa^a ; ^{gaichi.northriver@gmail.com} ; Kayo Katayama^a ; ^b ; Atsuko Furuno^a ; Yukiko Okada^a ; Asuna Yumori^a ; Hideya Sakakibara^a ; Hiroyuki Shigeta^b ; Hiroshi Yoshida^a ; ^b
• 关键词：endometrial cancer ; extrafascial hysterectomy ; surgical complications ; total laparoscopic modified radical hysterectomy
• 刊名：Gynecology and Minimally Invasive Therapy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：6
• 期：1
• 页码：6-11
• 全文大小：208 K
• 卷排序：6

文摘

In order to reduce the risk of vaginal recurrence, we have chosen total laparoscopic modified radical hysterectomy instead of extrafascial hysterectomy in the treatment of endometrial cancer. The aim of this study was to assess the safety of this method.DesignRetrospective study of gynecological patients.SettingYokohama City University Medical Center, Yokohama, Japan.PatientsForty-nine patients who underwent total laparoscopic modified radical hysterectomy for the treatment of endometrial cancer at our hospital between December 2011 and September 2015.InterventionsTotal laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy (n = 20), total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic lymphadenectomy (n = 18), or total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic and para-aortic lymphadenectomy (n = 11).Measurements and Main ResultsThe surgical outcomes were analyzed and compared to previous reports. The median operative time was 204 minutes (range, 99–504 minutes) and the median intraoperative blood loss was 150 mL (range, 0–680 mL). No patients needed a blood transfusion, conversion to laparotomy, or reoperation. Intra- and postoperative complications were observed in three patients and nine patients, respectively. The amount of blood loss and the incidence of complications in our study were almost identical to previous reports of laparoscopic hysterectomy. The operative time in our study was equivalent to previous reports of total laparoscopic modified radical hysterectomy.ConclusionTotal laparoscopic modified radical hysterectomy is safe and feasible for the treatment of early stage endometrial cancer. This procedure can be an alternative to total laparoscopic hysterectomy, especially when the uterus must be removed completely.