Objective: To assess the place of laparoscopically assisted vaginal hysterectomy in the treatment of endometrial cancer.
Design: A retrospective uncontrolled case series.
Setting: Gynaecological Oncology Department, Queen Elizabeth Hospital, Gateshead.
Population: Women with endometrial cancer referred to this centre from August 1992 to August 1997.
Main outcome measures: Success of laparoscopically assisted vaginal hysterectomy, operative morbidity, and the length of hospital stay.
Results: Laparoscopically assisted vaginal hysterectomy was successful in 35 of 40 women (88%). Five women required laparotomy. Two women sustained injury to the inferior epigastric vessels. One sustained injury to the small intestine requiring later laparotomy and three women required a blood transfusion. The mean hospital stay was 3 x 3 days (SD 1 x 5). Three women died of the disease within one year of their operation.
Conclusion: Laparoscopically assisted vaginal hysterectomy is a feasible treatment for endometrial cancer. It can be performed successfully in high risk population who are medically unfit and overweight. However, a larger randomised study is required to assess the morbidity compared with the traditional open approach.