期刊
EUROPEAN JOURNAL OF CANCER
卷 48, 期 8, 页码 1147-1153出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2012.02.055
关键词
Endometrial cancer; Safety; Surgery
类别
资金
- Cancer Council Queensland
- Cancer Council New South Wales
- Cancer Council Victoria
- Cancer Council Western Australia
- NHMRC [456110]
- Cancer Australia Project Grant [631523]
- Women and Infants Research Foundation, Western Australia
- Royal Brisbane and Women's Hospital Foundation
- Wesley Research Institute
- Gallipoli Research Foundation
- Gynetech
- TYCO Healthcare, Australia
- Johnson and Johnson Medical, Australia
- Hunter New England Centre for Gynaecological Cancer
- Genesis Oncology Trust
- QLD Health
Aim: To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety. Methods: Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up. Postoperative AEs were graded according to Common Toxicity Criteria (V3), and those immediately life-threatening, requiring inpatient hospitalisation or prolonged hospitalisation, or resulting in persistent or significant disability/incapacity were regarded as serious AEs. Results: The incidence of intra-operative AEs was comparable in either group. The incidence of post-operative AE CTC grade 3+ (18.6% in TAH, 12.9% in TLH, p 0.03) and serious AE (14.3% in TAH, 8.2% in TLH, p 0.007) was significantly higher in the TAH group compared to the TLH group. Mean operating time was 132 and 107 min, and median length of hospital stay was 2 and 5 days in the TLH and TAH group, respectively (p < 0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2 g/L less in the TLH group (p 0.006). Conclusions: Compared to TAH, TLH is associated with a significantly decreased risk of major surgical AEs. A laparoscopic surgical approach to early stage endometrial cancer is safe. (C) 2012 Elsevier Ltd. All rights reserved.
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