Safety of laparoscopy vs laparotomy in the surgical staging of endometrial cancer: a systematic review and metaanalysis of randomized controlled trials

The aim of the current study was to compare the safety of the laparoscopic vs abdominal approach to staging endometrial cancer. A search was conducted for randomized controlled trials that reported data from women with histologically confirmed endometrial cancer who underwent laparoscopic or abdominal surgery. An additional metaanalysis was performed. The primary endpoints were the rates of intraoperative and postoperative complications. A total of 8 original randomized controlled trials were included in the final analysis. No significant difference was observed in the relative risk (RR) for intraoperative complications between laparoscopy and laparotomy (RR, 1.25; 95% confidence interval, 0.99-1.56; P = .062). In contrast, a significant advantage of laparoscopy over laparotomy was obtained in terms of postoperative complications (RR, 0.71; 95% confidence interval, 0.63-0.79; P = .016). In comparison with abdominal surgery, the safety of the laparoscopic approach for surgical staging of endometrial cancer is similar in terms of intraoperative complications but results in fewer postoperative complications.