Total Laparoscopic Hysterectomy versus Laparoscopic-Assisted Vaginal Hysterectomy in Endometrial Cancer: Surgical and Survival Outcomes

Study objective: To compare Surgical and survival outcomes of Patients Willi early-stage endometrial cancer (EC) Who underwent total laparoscopic hysterectomy (TLH) or laparoscopic-assisted vaginal hysterectomy (LAVH) +/- lymphadenectomy Design: Retrospective. nonrandomized clinical study (Canadian Task Force classification II-2). Setting: Two tertiary care academic medical centers. Patients: Patients with EC treated by TLH or LAVH from 1998 through 2006. Interventions: TLH and LAVH were performed in 80 and 24 patients. respectively. Patient demographics and clinical variables were collected, and surgical and survival outcomes were determined. Measurements and Main Results: Median operating time wits significantly higher for patients undergoing LAVH than for those undergoing TLH (212.5 and 183.5 minutes, respectively; p = .039). EBL was also greater in patients undergoing LAVH (median 220 mL) compared with those undergoing TLH (median 100 mL; p = .001). After a median follow-up time of 51.5 months, there Was no difference ill recurrence Or survival rates between the groups. Conclusion: Early-stage EC can be treated effectively Willi either TLH or LAW TLH patients may experience shorter operating times and less blood loss. When pet-Conned by experienced laparoscopists, TLH may lie more feasible than LAVH in this cohort of patients. Journal of minimally Invasive Gynecology (2009) 16, 333-9 (c) 2009 AAGL All rights reserved.