Evaluation of the Usefulness of Laparoscopic Surgery for Early Endometrial Carcinoma in Our Facility

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  • MIYAMOTO Tsutomu
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • KASHIMA Hiroyasu
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • KOBARA Hisanori
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • YAMADA Yasushi
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • TACHIBANA Ryota
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics and Gynecology, Iida Municipal Hospital
  • TANAKA Yasuhiro
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics and Gynecology, Suwa Red Cross Hospital
  • NAKAJIMA Masako
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics and Gynecology, Ina Central Hospital
  • SHINAGAWA Manaka
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine Department of Obstetrics and Gynecology, Iida Municipal Hospital
  • FUNAMOTO Hiroshi
    Department of Obstetrics and Gynecology, Toyama Prefectural Central Hospital
  • SHIOZAWA Tanri
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine
  • OKA Kenji
    Department of Obstetrics and Gynecology, Shinshu University School of Medicine

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Other Title
  • 当科における早期子宮体がんに対する腹腔鏡下根治術の有用性の検討
  • トウ カ ニ オケル ソウキ シキュウタイ ガン ニ タイスル フククウキョウ カ コンジジュツ ノ ユウヨウセイ ノ ケントウ

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Abstract

Background : Laparoscopic surgery for early endometrial carcinoma (EC) has been covered by the national health insurance system of Japan since 2014. Our facility introduced this surgery in 2016, and 27 surgeries were performed as of December 2017. The outcomes and safety of laparoscopic surgery (TLH group) for early endometrial carcinoma were evaluated herein and compared with those of conventional laparotomy (TAH group).<br>Methods : The surgery-related data of 27 cases in the TLH group and 49 in the TAH group were extracted from medical records and the results obtained were compared.<br>Results : No significant differences were observed in patient backgrounds between the two groups, except for pelvic lymphadenectomy, which was performed on only 4 cases in the TLH group. Surgical time was longer in the TLH group than in the TAH group (201.1±44.8 vs. 176.8±29.3 min, P<0.001), whereas total blood loss was less (29.7±25.0 vs. 162.4±135.8 mL, P<0.001). The adverse events of ileus and hematoma/postoperative hemorrhage were only observed in the TAH group. The duration of the postoperative hospital stay was shorter in the TLH group (6.1±3.5 vs. 8.9±3.7 days, P<0.001). The mode of surgery did not affect the postoperative pathological diagnosis or recurrence/survival ; however, observation periods were inadequate.<br>Conclusions : Laparoscopic surgery appears to be safe for early EC in our facility without the loss of radicality or occurrence of adverse events, such as ileus and postoperative bleeding. The accumulation of more cases is needed to refine this procedure.

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