Laparoscopic Surgery For Endometrial Cancer Clinical And Evidence-based Medical Research

OBJECTIVE To investigate the clinical effect and the survival analysis of laparoscopy compared with laparotomy in management of endometrial carcinoma, and to explore its prognostic factors.METHODS Retrospective the consecutive cases with endometrial carcinoma from January 2002 to May 2010 were documented, including 51 patients underwent laparoscopy, and 213 patients underwent laparotomy as control group. The data of operative time,blooding loss,the number of pelvic,postoperative recovery times of rectal function, urinary catheterization time,hospital days,recurrence rate,overall survival and disease-free survival rate. All were compared between groups.RESULTS There were significant difference in blood loss during operation, the recovery time of bowel, urinary catheterization time and hospital days between laparoscopic group and laparotomy group(P<0.05). The pelvic lymph nodes resected in laparoscopic group was significantly less than that in laparotomy group(P<0.05). was found between groups on the There was no significant difference in the recurrence rate,overall survival rate and disease free survival rate between between laparoscopic group and laparotomy group (P>0.05).CONCLUSION Laparoscopy is a safe and effective alternative to conventional abdominal surgery for endometrial cancer. OBJECTIVE To systematically evaluate the effects of laparoscopy compared with laparotomy in treating endometrial cancer.METHODS Electronic searches was conducted to identify randomised controlled trials (RCTs) for comparing the effects of laparoscopy versus the effects of traditional procedure (laparotomy) in treating endometrial carcinoma.RESULTS 8RCTs were included. Results of Meta-analysis showed that the laparoscopy could have less operative blooding losses(WMD=-89.37,95%CI-123.03,-55.70),Hemoglobin is higher than laparotomy (preoperative–postoperative day 5d) ( WMD=-1.14 ,95%CI-1.48,-0.81),Shorten postoperative recovery times of rectal function and hospital days than laparotomy ( WMD=-14.69 ,95%CI-26.96,-2.41;WMD=-3.49,95%CI-4.94,-2.04),decreased rate of intra-operative complications and post-operative complications rate(OR=0.54,95%CI0.35,0.84;OR=0.37,95%CI0.24,0.58),There is no significant difference in operative times and the number of pelvic lymphectomy than laparotomy. ( WMD=13.86 , 95%CI-23.64 ,51.36;WMD=0.69,95%CI-0.46,1. 84),even have more numbers of para-aortic lymphectomy than laparotomy(WMD=1.66,95%CI1.03, 2.28),There is no significant difference in recurrence rate and overall survival and disease-free survival and dead rate(OR=0.83,95%CI0.51,1.36;OR=0.94,95%CI0.55,1.61;OR=1.34,95%CI0.66,2.75;OR=0.94,95%CI0.40,2.21)。CONCLUSION Our data suggest that laparoscopic approach should be considered an effective and safe procedure for patients with endometrial cancer as well as laparotomic one.