Outcome of Laparoscopic and Abdominal Hysterectomy for Management of Early-Stage Endometrial Carcinoma
DOI:
https://doi.org/10.64149/J.Carcinog.24.5s.563-573Keywords:
Endometrial carcinoma, Laparoscopic hysterectomy, Abdominal hysterectomy, Minimally invasive surgery, Gynecologic oncologyAbstract
Background: Endometrial cancer (EC) is the commonest gynecologic malignancy in developed countries. Early-stage EC often has a favorable prognosis, with surgery being the primary treatment.
Aim: This study aimed to assess the outcomes of total laparoscopic hysterectomy (TLH) vs. total abdominal hysterectomy (TAH) in managing early-stage EC in a low resource country.
Patients and Methods: This randomized clinical trial included 83 females with FIGO stage I–II EC, allocated into two groups: 46 females underwent total abdominal hysterectomy ± lymphadenectomy (Group A) and 37 females had total laparoscopic hysterectomy ± lymphadenectomy (Group B).
Results: TLH was associated with significantly shorter hospital stays (median 5 days), shorter operative time (median 105 minutes), less blood loss (median 275ml), and fewer blood transfusions (3 cases only received one unit of packed RBCs). There were no reported cases of wound infection or seroma in the laparoscopic group. Bladder and ureteric injuries were reported in 5.4% and 2.7% respectively in the laparoscopic group. Post operative hemoglobin and hematocrit vales were statistically significant lower in the abdominal group than in the laparoscopic group (9.8±0.6, 11.2±1.0 & 39.4±2.4, 41.7±2.9 p value ≤0.001 & ≤0.001 respectively). Notably, four deaths occurred in the abdominal group (8.7%). Pulmonary embolism, sepsis, intestinal obstruction and hepatic encephalopathy were the main causes of mortality in the abdominal group.
Conclusion: Laparoscopic hysterectomy offers superior perioperative outcomes and fewer complications compared to the abdominal approach, supporting its use as a safe and effective treatment for early-stage EC management.
