Laparoskopisch-assistierte vaginale versus abdominale Operationstechnik bei Patientinnen mit Endometriumkarzinom - Eine prospektiv randomisierte Studie

Purpose: We compared a laparoscopic-vaginal with a conventional abdominal approach for treatment of patients with endometrial cancer. Patients and Methods: Between Julyl995 and May 2001 98 patients with endometrial cancer FIGO stage I-III were randomized to laparoscopic-assisted simple or radical vaginal hysterectomy or simple or radical abdominal hysterectomy with or without lymph node dissection. Results: 52 patients were treated in the laparoscopic versus 46 patients in the laparotomy group. Lymph node dissection was performed in 36 patients by laparoscopy and in 38 patients by laparotomy. Blood loss, transfusion rates, long term complications and duration of hospital stay were significantly lower in the laparoscopic group. Yield of pelvic and para-aortic lymph nodes, duration of surgery, and incidence of intra- and postoperative complications were similar for both groups. Overall- and recurrence-free survival did not differ significantly for both groups. Conclusion: The laparoscopic-vaginal approach for treatment of endometrial cancer is associated with lower perioperative and long-term morbidity compared with the conventional abdominal approach.