Comparative analysis of laparoscopic surgery and laparotomy for management of endometrial cancer

Between September 2010 and September 2012, a total of 200 patients with endometrial cancer underwent surgery or received combined modality treatment at the N.N. Petrov Research Institute of Oncology. Of these patient, 100 (Group I) underwent laparoscopic surgery using Karl Storz laparoscope and 100 (Group II) underwent laparotomy. No significant differences in the age, extent of tumor involvement and the presence of concomitant diseases between groups were found. Grade III obesity was revealed in 14,0 % of Group I patients and in 11.0% of group II patients. The length of surgery and the average intraoperative hemorrhage in Groups I and II were 136 ± 0,95 and 108 ± 0,45 min; 32,95 (10–265) and 207,4 (90–500) mL, respectively. No intraoperative complications were registered. Postoperative lymphogenic complications (iliac lymphocystis, lymphorrhea and lymphangiectatic edema) were observed in 53,3 % and 52,2 % of patients in groups I and II, respectively. Thromboembolic complications occurred only in group II patients, in 5 % of cases. The average number of the removed right and left pelvic lymph nodes was 9,75 and 10,15 in group I and 7,97 and 9,04 in group II, respectively. Physical activity of patients on day 1 after surgery was registered more often after laparoscopic surgery (59 % of patients) than after laparotomy (27 % of patients). Accordingly, videoendoscopic technologies allow the adequate extent of radical surgery to be performed in endometrial cancer patients irrespective of the age and the presence of concomitant disease. Laparoscopic approach provides minimum surgical trauma and leads to less frequent wound complications and favorable postoperative period.