Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: results from a randomised controlled trial
| Autor: | Anthony J. McCartney, Peter Sykes, Thomas Manolitsas, Srinivas Kondalsamy-Chennakesavan, Jannah Baker, Marcelo Nascimento, Stuart G. Salfinger, David H. Wrede, Deborah Neesham, Bryony Simcock, Gregory Robertson, Graeme J. Walker, Rhonda Farrell, Martin K. Oehler, James L. Nicklin, Val Gebski, Kar Fai Tam, Russell Land, Tong Yow Ng, Andrea Garrett, Selvan Pather, Michael Laney, Geoff Otton, Monika Janda, Hextan Y.S. Ngan, Tom Jobling, Andreas Obermair, Ian Hammond, Lewis Perrin, Alison Brand, Russell Hogg, Yee Leung, Karen Chan |
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| Rok vydání: | 2011 |
| Předmět: |
Laparoscopic surgery
Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Hysterectomy law.invention Randomized controlled trial law Laparotomy medicine Humans Laparoscopy Adverse effect Aged Neoplasm Staging medicine.diagnostic_test business.industry Endometrial cancer Length of Stay Middle Aged medicine.disease Surgery Endometrial Neoplasms Clinical trial Oncology Lymph Node Excision Female business |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 48(8) |
| ISSN: | 1879-0852 |
| Popis: | To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety.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.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 (p0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2g/L less in the TLH group (p 0.006).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. |
| Databáze: | OpenAIRE |
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