Hilaris Georgios E, Tsoubis Thomas, Konstantopoulos Vasilios, Pavlakis Kitty
Adjunct Clinical Instructor of Obstetrics and Gynecology, Department of Obstetrics & Gynecology and Center for Special Minimally Invasive and Robotic Surgery, Stanford University School of Medicine, Stanford, California, USA.
JSLS. 2009 Oct-Dec;13(4):489-95. doi: 10.4293/108680809X12589998403886.
The role of laparoscopy in the management of early stage endometrial and cervical cancer is continuously validated by many reports throughout the world. Interestingly, such data are still unavailable in many European countries, as it is in Greece. In this prospective study, we report on initial feasibility, safety, and cost outcomes of laparoscopic management of early stage endometrial and cervical cancer, recently introduced in our country.
This was a prospective pilot study comprising a case series. Patients referred to a tertiary referral medical center with a recent diagnosis of endometrial or cervical cancer were evaluated, and those meeting inclusion criteria were offered laparoscopic surgical staging.
Out of 64 patients evaluated, 17 with early clinical stage endometrial cancer and 8 with early clinical stage cervical cancer underwent successful laparoscopic staging. Mean patient age was 61.6 and 39.2 years, mean BMI was 32.3 and 24.1kg/m(2), mean operative time was 243 and 284 minutes, mean estimated blood loss was 190mL and 270mL, mean lymph node count was 27.2 and 29.1, and mean hospital stay was 2 and 3 days for endometrial and cervical cancer cases, respectively. The overall costs for the procedures performed were not greater than their laparotomy counterpart. One intraoperative complication was managed laparoscopically, and 2 cases occurred of postoperative lymphocyst formation.
To our knowledge, this is the first study of laparoscopic management of early endometrial and cervical cancer in Greece. Our preliminary data support the feasibility, safety, and cost effectiveness of laparoscopic management of early endometrial and cervical cancer in our country and are in accordance with series reported in the international literature.
全世界许多报告不断证实腹腔镜检查在早期子宫内膜癌和宫颈癌治疗中的作用。有趣的是，在许多欧洲国家，如希腊，仍缺乏此类数据。在这项前瞻性研究中，我们报告了我国最近引入的早期子宫内膜癌和宫颈癌腹腔镜治疗的初步可行性、安全性和成本结果。
这是一项包含病例系列的前瞻性试点研究。对转诊至三级转诊医疗中心且近期诊断为子宫内膜癌或宫颈癌的患者进行评估，符合纳入标准的患者接受腹腔镜手术分期。
在评估的64例患者中，17例早期临床分期的子宫内膜癌患者和8例早期临床分期的宫颈癌患者成功接受了腹腔镜分期。子宫内膜癌患者的平均年龄为61.6岁，宫颈癌患者为39.2岁；平均体重指数分别为32.3和24.1kg/m²；平均手术时间分别为243和284分钟；平均估计失血量分别为190mL和270mL；平均淋巴结计数分别为27.2和29.1；子宫内膜癌和宫颈癌患者的平均住院时间分别为2天和3天。所进行手术的总体费用不高于开腹手术。1例术中并发症通过腹腔镜处理，2例发生术后淋巴囊肿。
据我们所知，这是希腊第一项关于早期子宫内膜癌和宫颈癌腹腔镜治疗的研究。我们的初步数据支持我国早期子宫内膜癌和宫颈癌腹腔镜治疗的可行性、安全性和成本效益，并且与国际文献报道的系列研究结果一致。
