[Comparison of surgery for staging using laparoscopy and laparotomy in patients with endometrial cancer].

Objective: To compare the surgical outcomes for staging by laparoscopy and laparotomy in patients with endometrial cancer, evaluate the feasibility of laparoscopic surgical treatment of endometrial cancer, compare the difference between clinical and surgical staging of endometrial cancer and elucidate the advantages and feasibility of its surgical staging.

Methods: Fifty-six patients diagnosed pre-operatively as stage I endometrial cancer were reviewed for surgery for staging. They were assigned into laparoscopic group (n = 34) and laparotomic (open) group (n = 22). The operative parameters including operating time, intra-operative blood loss, the number of lymph nodes removed, gastrointestinal recovery time, urinary catheterization time, complications and post-operative hospital stay were compared.

Results: The pre-operative clinical characteristics before operation between two groups were similar. No significant differences were found in age and body mass index between two groups. As compared with the open group, the laparoscopic group had a longer operation time (213 min ± 49 min vs 162 min ± 30 min, P < 0.05), less hemoglobin change (12 g/L ± 8 g/L vs 19 g/L ± 8 g/L, P < 0.05), shorter hospital stay (6.3 d ± 1.7 d vs 9.5 d ± 1.8 d, P < 0.01) and shorter gastrointestinal recovery time (1.8 d ± 0.6 d vs 2.7 d ± 1.2 d, P < 0.01). While there was no significant difference between two groups in the number of lymph nodes removed, urinary catheterization time, costs and complications. The total coincidence was 57.14% between clinical and surgical staging.

Conclusion: Laparoscopic staging surgery is both feasible and safe in the treatment of endometrial cancer. And the surgical staging truly reflects the extent of cancer invasion and it is thus necessary for early-stage endometrial cancer.