Adverse events associated with laparoscopy vs laparotomy in the treatment of endometrial cancer

Am J Obstet Gynecol. 2011 Aug;205(2):143.e1-6. doi: 10.1016/j.ajog.2011.03.012. Epub 2011 Mar 16.

Abstract

Objective: The objective of the study was to compare adverse event rates between laparoscopic vs open surgery for endometrial cancer.

Study design: This was a retrospective cohort study comparing 107 women who underwent laparoscopy with 269 age- and body mass index-matched women who underwent laparotomy for treatment of endometrial cancer.

Results: Adverse event rates were similar between cohorts (37% laparoscopy vs 43% laparotomy, P=.248). Laparotomies had higher rates of cellulitis (16% vs 7%, P=.018) and open wound infection (9% vs 2%, P=.02), whereas laparoscopy had higher rates of sensory peripheral nerve deficit (5% vs 0%, P=.008) and lymphedema (7% vs 1%, P=.003). Laparoscopy was associated with longer mean operating room times but with shorter hospital stays and lower mean blood loss.

Conclusion: Laparoscopy was associated with decreased rates of surgical site infections but had an increased risk of peripheral sensory nerve deficits and lymphedema when compared with laparotomy.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / surgery
  • Adult
  • Aged
  • Cohort Studies
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / methods*
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Laparotomy / adverse effects*
  • Laparotomy / methods
  • Length of Stay / trends
  • Lymph Node Excision / methods
  • Lymph Node Excision / statistics & numerical data
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology
  • Time Factors
  • Treatment Outcome