Laparoscopic and laparotomic approaches for endometrial cancer treatment: a comprehensive review

Abstract

Objective: Endometrial cancer (EC) is the most common gynecological malignancy in the developed world, particularly among postmenopausal women. Endoscopic surgery is gaining more popularity among surgeons as a safe and feasible option for treatment of endometrial carcinoma, providing the possibility of adequate lymph node excision.

Methods: A comprehensive review.

Results: The advantages of laparoscopy prevail over laparotomy and authors report lower peri-operative complication rates, less blood loss, lower transfusion rates, and shorter hospital stay, as well as a better quality of life (QoL) after laparoscopic surgery, in contrast to conventional abdominal surgery. This was confirmed by a meta-analysis of four randomized controlled studies. This is also true for obese risky patients to whom laparotomies carry indolent side effects. In addition, with more training and experience this procedure would be even more feasible and safer.

Conclusions: Because of the increasing importance of economic efficiency in health care, the endoscopic approach will continue to play a more important role in the future treatment of EC providing a better treatment option for the coming patients. As a promising therapeutical option, it should be offered to all patients with an early-stage EC.