Laparoscopy for the treatment of women with endometrial cancer.

OBJECTIVE To evaluate the use of a laparoscopic approach for the management of endometrial cancer. DESIGN Retrospective study. SETTING Regional hospital, Hong Kong. SUBJECTS AND METHODS Individual medical records of patients with preoperative histological diagnosis of endometrial carcinoma from January 2000 to December 2001 were reviewed and the data analysed. MAIN OUTCOME MEASURES Success of laparoscopic-assisted surgical staging, intra-operative and postoperative morbidity, and length of hospital stay. RESULTS Laparoscopic surgery was successful for 93.3% (28 of 30) patients. Two patients were converted to laparotomy. The mean operating time was 102 minutes (standard deviation, 16 minutes) and the mean operative blood loss was 280 mL (standard deviation, 137 mL). The mean hospital stay was 5 days (standard deviation, 2.3 days). The intra-operative and postoperative complication rate was 16.7%, including vaginal tear, injury to the inferior epigastric vessel, lymphocyst, and pulmonary embolism. CONCLUSION This study illustrated that a laparoscopic approach is feasible for endometrial cancer surgery and may be considered as the primary treatment modality in skilled hands. This approach should be offered to women with endometrial cancer without contraindications for laparoscopic surgery if experienced endoscopic surgeons are available. Prophylaxis for venous thromboembolism and the use of retroperitoneal drainage may be helpful in decreasing the perioperative morbidity.