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Am J Obstet Gynecol. 2011 Dec;205(6):565.e1-6. doi: 10.1016/j.ajog.2011.06.081. Epub 2011 Jun 29.

Evolution of surgical management of early-stage endometrial cancer.

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  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA. dboruta@partners.org

Abstract

OBJECTIVE:

We sought to examine the evolution of surgical care for early-stage endometrial cancers and factors affecting use of laparoscopy.

STUDY DESIGN:

Women with surgically managed early-stage endometrial cancer were divided into 2 groups corresponding to before and after addition of faculty with formal fellowship training in laparoscopic staging and access to a robotic surgery platform.

RESULTS:

In all, 502 women were identified. Laparoscopic management increased from 24-69% between time periods (P < .0001). Performance of comprehensive surgical staging, and lymph node counts, increased (P < .0001) despite an increase in median body mass index (P = .001). A traditional "straight stick" technique was performed in 72% of laparoscopic cases during the later period. Laparoscopy patients had lower estimated blood losses and shorter hospital stays (each P < .0001) compared to laparotomy patients.

CONCLUSION:

Addition of faculty with formal fellowship training in laparoscopic staging and access to a robotic surgery platform shifted management of early-stage endometrial cancer toward laparoscopy.

Copyright © 2011 Mosby, Inc. All rights reserved.

PMID:
21855843
[PubMed - indexed for MEDLINE]
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