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J Minim Invasive Gynecol. 2016 Mar-Apr;23(3):378-83. doi: 10.1016/j.jmig.2015.11.006. Epub 2015 Nov 18.

Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer: A Single-Institution Retrospective Cohort Study.

Author information

  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gueliallettis@gmail.com.
  • 2Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
  • 3Department of General Surgery and Medical Surgical Specialties, Gynecologic Clinic, University of Catania, Catania, Italy.
  • 4Institute for Maternal and Child Health-IRCCS Burlo Garofolo, University of Trieste, Trieste, Italy.
  • 5Department of Medicine and Aging Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti and Pescara, Italy.
  • 6Division of Minimally Invasive Gynecology, St. Maria Hospital, University of Perugia, Terni, Italy.

Abstract

STUDY OBJECTIVE:

To compare the surgical and clinical outcomes of patients affected by early-stage endometrial cancer treated using the Telelap ALF-X platform versus conventional laparoscopic surgery.

DESIGN:

Single institution retrospective cohort study (Canadian Task Force classification II-2).

SETTING:

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.

PATIENTS:

The study involved 89 patients affected by early-stage endometrial cancer who underwent elective surgical staging between October 2013 and September 2014. Among them, 43 (48.3%) underwent Telelap ALF-X staging (ALF-X group), and 46 (51.7%) underwent conventional laparoscopic staging (laparoscopic group).

INTERVENTIONS:

All selected patients underwent laparoscopic staging with radical hysterectomy (class A sec Querleu-Morrow), bilateral salpingo-oophorectomy, and pelvic lymphadenectomy if required. The 2 surgical groups were further divided into patients who did not require pelvic lymphadenectomy (subgroup 1) and those who underwent pelvic lymphadenectomy (subgroup 2).

MEASUREMENTS AND MAIN RESULTS:

In the ALF-X group, the median operative time was 128 minutes (range, 69-260 minutes) for subgroup 1 and 193 minutes (range, 129-290 minutes) for subgroup 2. In the laparoscopic group, the median operative time was 82 minutes (range, 25-180 minutes) in subgroup 1 and 104 minutes (range, 36-160 minutes) in subgroup 2. The difference in operative time between subgroups was statistically significant in both the ALF-X and laparoscopic groups (p = .000). In subgroup 1 of the ALF-X group, there was 1 conversion to standard laparoscopy (2.3%) and 2 conversions to laparotomy (4.7%) (p = .234). No conversions to laparotomy occurred in the laparoscopic group. Postoperative complications included 1 case of pelvic hematoma (2.3%) in subgroup 1 of the ALF-X group and 1 case of subocclusion and 1 case of pulmonary edema (4.3%) in subgroup 1 of the laparoscopic group.

CONCLUSION:

Based on operative outcomes and complication rates, our results suggest that the Telelap ALF-X approach is feasible and safe for endometrial cancer staging; however, further studies are needed to definitively assess the role of Telelap ALF-X early-stage endometrial cancer staging.

KEYWORDS:

ALF-X; Endometrial cancer; Endoscopy; Laparoscopy; Robotic surgery

PMID:
26602025
DOI:
10.1016/j.jmig.2015.11.006
[PubMed - indexed for MEDLINE]
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