A Comparative Cohort Study of Laparoscopy Versus Laparotomy for the Treatment of Iranian Endometrial Cancer Patients

Abstract

Background: In recent decades, laparoscopy and robotic surgery are mostly used for the treatment of endometrial cancer. Laparoscopic surgery's popularity has grown due to rapid postoperative recovery and reduced post-surgical morbidity and complications compared with open surgery. Objectives: This study aimed to compare laparoscopic surgery and laparotomy in terms of their advantages and disadvantages for treating early-stage endometrial cancer in a population of Iranian patients in a referral center of gyneco-oncology. Methods: In this cohort study at Imam Hossein Medical Center in Tehran, Iran, from 2019 to 2022, early-stage endometrial cancer patients were included. Advanced disease, patients with medical comorbidity not suitable for laparoscopy, previous surgery for endometrial cancer, and prior chemotherapy or radiotherapy for treatment of the endometrial cancer were excluded from the study. The study compared two groups regarding operative findings, including FIGO stage, grade, postoperative complications, and hospitalization days. Results: The study included 17 patients in the laparoscopic group with a mean age of 56(+ 12.5) years old and 44 patients in the laparotomy group with a mean age of 57(+ 10.2) years old. Two groups were well-matched in terms of body mass index and menopausal status. The median intraoperative blood loss was significantly in terms of statistical less in the laparoscopic group (200 ml versus 500 ml, P = 0.001). Four (23.5%) patients in the laparoscopic group needed intraoperative blood transfusion versus 22 (50.0%) in the laparotomy group, P = 0.061. Hospital stay days were shorter in the laparoscopic group, with a median of three versus six days (P < 0.001). Conclusions: In conclusion, the minimally invasive operation caused less blood loss, hospital stay, and blood transfusion in comparison to laparotomy in Iranian endometrial cancer patients, confirming the preferred method of laparoscopy in these patients.