Objective: The aim of this study was to assess the effect of increasing surgeons's experience in the laparoscopic surgery of women with endometrial cancer (EC) on the surgical outcome of these patients.
Study Design: Data were obtained from a prospectively collected database of 108 patients two oncolaparoscopic centers in Czech Republic who underwent laparoscopically assisted surgical staging (LASS) from April 1996 to March 2001. Patients were arranged in chronological order and divided into three groups, based on the date of their surgery. The three groups were compared in patient characteristics and surgical outcome using one-way analysis of variance (ANOVA) and Wilcoxon rank sum test.
Setting: Department of Obstetrics and Gynecology, Endoscopic Training Center, Baby Friendly Hospital Kladno, Czech Republic.
Results: The three groups were similar in patient characteristics. Operative times for laparoscopic staging with pelvic lymphadenectomy (LN) decreased significantly from mean of 156.3 min for group 1 to 142.8 min for group 3 (P < 0.05). In cases LASS with pelvic lymphadenectomy was significant increase in the number lymph nodes harvested (12.4 for group 1, 13.9 for group 2, and 15.4 for group 3, P < 0.05). In cases LASS without lymphadenectomy was not significant difference in operating time, estimated blood loss, rate of conversion to laparotomy, operative complications, and length of hospital stay among the compared groups. The number of patients who underwent para-aortic lymphadanectomy was too small (n = 22), and their distribution was asymmetrical for comparison.
Conclusion: A learning curve is demonstrated in the LASS of women with endometrial cancer. With increasing surgeon's team experience, there is significant decrease in operative time for staging with pelvic lymph node dissection and increase in the number of pelvic lymph nodes removed. The para-aortic lymphadenectomy (PALN) was found to be more challenging than pelvic lymphadenectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0301-2115(02)00373-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Oncologic and pregnancy outcomes of fertility-sparing treatment with medroxyprogesterone acetate in women with premalignant and malignant endometrial lesions: A case series.
Eur J Surg Oncol
December 2024
Department of Anatomy, Medicine and Surgery, University of Malta, Msida, MSD2080, Malta.
Introduction: Current trends of delaying childbearing and the increasing incidence of endometrial cancer in nulliparous woman necessitate research and development of fertility sparing treatments. Hormonal therapy with progestins offers an alternative to surgical treatment for a select group of patients of reproductive-age, who wish to preserve their reproductive potential.
Materials And Methods: The study evaluates the effectiveness of medroxyprogesterone acetate therapy in patients with early-stage endometrial cancer, atypical endometrial hyperplasia or atypical polypoid adenomyoma, seeking to preserve fertility.
Mid-infrared spectroscopy as a real-time diagnostic tool for chronic endometritis: A preliminary study.
Spectrochim Acta A Mol Biomol Spectrosc
December 2024
IVF Unit, Hillel Yaffe Medical Center, Hadera, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel.
Research Question: Can attenuated total reflection-Fourier transform infrared spectroscopy combined with machine learning techniques be used to develop a real-time diagnostic modality for chronic endometritis by analysing endometrial biopsies obtained during hysteroscopy?
Design: Women undergoing hysteroscopy for infertility assessment were enrolled in this prospective study from January 2020 to March 2021. Endometrial biopsies were evaluated using a spectrophotometer, and subsequently via histopathology, including immunohistochemical staining for the multiple myeloma oncogene-1 (MUM-1). Spectroscopy analyses of the positive and the negative chronic endometritis groups were compared across various cut-offs of MUM-1 positive cells per 10 high-power fields (HPF).
Lymph node assessment at the time of robotic hysterectomy for endometrial intraepithelial neoplasia: A cost-effectiveness analysis.
Gynecol Oncol
January 2025
Division of Gynecologic Oncology, St. Luke's University Health Network, Bethlehem, PA, United States of America.
Objective: We sought to determine the cost-effectiveness (CE) of lymph node dissection (LND) at the time of hysterectomy for endometrial intraepithelial neoplasia (EIN).
Methods: A decision analytic model was created to evaluate the strategies of routine full LND, sentinel lymph node dissection (SNLD), SNLD without advancing to full LND in the event of non-mapping, and full LND based on Mayo Criteria, versus no LND. Patients in the no LND group and those in the SLND group without advancement to full LND in the event of non-mapping who were found to have EC on final pathology and suspicious post-operative imaging underwent full LND.
A case of large uterine cystic adenomyosis outside the uterus after laparoscopic myomectomy: a case report and literature review.
BMC Womens Health
January 2025
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning Province, 110004, China.
Background: Uterine cystic adenomyosis is a rare form of focal adenomyosis that is primarily located within the myometrium. In this case report, we present a unique case of adult uterine cystic adenomyosis found outside the uterus following laparoscopic myomectomy.
Case Presentation: The patient was a 36-year-old Chinese woman who had previously undergone laparoscopic surgery at our hospital to remove a 4 cm diameter diameter uterine fibroid six years prior.
Hysteroscopic Endometrial Defect Following Adenomyomectomy and Incidence of Placenta Accreta Spectrum and Uterine Rupture Complications for Subsequent Pregnancy.
Reprod Sci
January 2025
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Adenomyomectomy, a therapeutic option for women with adenomyosis who wish to preserve their fertility, has been reported to pose a risk of developing placenta accreta spectrum (PAS) and uterine rupture in future pregnancies. However, the specific clinical factors contributing to these occurrences remain elusive. This study aimed to explore the association between hysteroscopic findings after adenomyomectomy and the incidence of PAS in subsequent pregnancies.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!