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Comparison of laparoscopy and laparotomy for endometrial cancer
Author(s) -
Zhang Hui,
Cui Jing,
Jia Lin,
Hong Shuhui,
Kong Beihua,
Li Dadong
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.10.022
Subject(s) - medicine , laparotomy , laparoscopy , endometrial cancer , confidence interval , odds ratio , randomized controlled trial , surgery , strictly standardized mean difference , cancer
Objective To compare the safety and efficacy of laparoscopy and laparotomy on clinical outcomes among patients with endometrial cancer. Methods Eligible randomized controlled trials (RCTs) conducted between 1966 and June 2010 were analyzed by meta‐analysis. Results Eight RCTs were included, with 3599 patients in total. No significant difference was observed between laparoscopy and laparotomy in overall (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.50–1.82; P = 0.892), disease‐free (OR, 0.96; 95% CI, 0.50–1.82; P = 0.892), or cancer‐related (OR, 0.90; 95% CI, 0.27–3.08; P = 0.871) survival. More intraoperative complications (OR, 1.33; 95% CI, 1.03–1.73; P = 0.030), fewer postoperative complications (OR, 0.59; 95% CI, 0.46–0.75; P < 0.001), longer operative time (standardized mean difference [SMD], 0.80; 95% CI, 0.46–1.15; P < 0.001), lower blood loss (SMD, −2.29; 95% CI, −3.67 to − 0.91; P = 0.001), and shorter hospital stay (SMD, −2.60; 95% CI, −3.47 to − 1.72; P < 0.001) were associated with laparoscopy. There was no significant difference between the groups in pelvic (SMD, 0.22; 95% CI, −0.03 to 0.48; P = 0.086) or para‐aortic (SMD, 0.54; 95% CI, −0.04 to 1.11; P = 0.067) lymph node yield. Conclusion Laparoscopy has short‐term advantages and seemingly equivalent long‐term outcomes and, in experienced hands, might be a feasible alternative to laparotomy for endometrial cancer.