Laparoscopic and Open Surgical Staging for Adenocarcinoma of the Endometrium: An Analysis

Balaji, R (2012) Laparoscopic and Open Surgical Staging for Adenocarcinoma of the Endometrium: An Analysis. Masters thesis, Cancer Institute (WIA), Chennai.


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ABSTRACT : Endometrial adenocarcinoma ranks third among gynaecological malignancies after cervix and ovarian cancer in India. The foundation of management of endometrial carcinoma is surgical staging in the form of peritoneal biopsies, omentectomy and pelvic and para aortic lymphadenectomy. The surgical staging is traditionally accomplished by laparotomy but the advent of laparoscopy has made possible this minimally invasive option to be used for achieving the same ends. A retrospective analysis of all patients who presented with adenocarcinoma of the endometrium and treated surgically at the Cancer Institute (WIA) from the year 2006 to 2010 was done. A total of 145 patients with adenocarcinoma of the endometrium that underwent surgical staging by open or laparoscopic method were analysed. Patient factors like age, BMI and co-morbid illnesses were not significantly different in the two groups. Laparoscopic surgery resulted in significant reduction in hospital stay and incidence of complications especially surgical site infections and paralytic ileus. While it was associated with a significantly prolonged operating time, there was no difference in the median blood loss compared to open surgery. The grade and stage distribution were comparable in the laparotomy and laparoscopy groups and the pelvic nodal yield was equal if not better in the latter group with a trend towards improving nodal yield with the increasing surgical experience of the operating surgeon. Though long term data was not available, short term results showed that there was no significant difference in the 2-year overall survival and disease free survival between the two groups was there any statistically significant difference in the recurrence rate or disease specific mortality thus proving that laparoscopic approach to surgical staging in carcinoma Endometrium can be performed as safely as the conventional open approach without compromising on the operative, pathological and oncological outcomes. Key Words: Endometrial adenocarcinoma, surgical staging, laparoscopic hysterectomy, laparoscopic staging, laparoscopic lymphadenectomy, outcomes of laparoscopic staging, complications of laparoscopic staging AIM OF THE STUDY : Primary objective: 1. To compare the patient, surgical, pathological and treatment characteristics of open and laparoscopic surgical staging for adenocarcinoma of the endometrium 2. To analyse the factors affecting the above outcomes after laparoscopic and open surgical staging for adenocarcinoma of the endometrium Secondary objective: to determine the disease free survival (dfs) and overall survival (os) after open and laparoscopic surgical staging for adenocarcinoma of the endometrium

Item Type: Thesis (Masters)
Uncontrolled Keywords: Laparoscopic ; Open Surgical Staging ; Adenocarcinoma ; Endometrium ; Analysis.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Subramani R
Date Deposited: 19 Aug 2017 03:33
Last Modified: 09 May 2018 18:11

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