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Endometrial cancer keyhole surgery compared to open operation

9th Apr 17

Endometrial cancer is increasing in incidence, because it is more common in obese patients, and the incidence of obesity in the Australian community is increasing. Treatment involves surgical removal of uterus (hysterectomy), tubes and ovaries, and in high-risk cases, pelvic lymph nodes.

Traditionally, the surgery has been performed at open operation, via an incision extending from the navel to the pubic bone. Since the early 1990s, some surgeons have used “keyhole” or laparoscopic surgery in order to perform the surgery. The laparoscopic approach is clearly associated with less post-operative pain, earlier discharge from hospital, and earlier return to work, so there are cost-saving benefits, but the question has always been whether these short-term benefits are attained at the expense of long-term survival.

This week, the results of an international trial comparing open surgery with laparoscopic surgery for patients with stage I endometrial cancer were published in Journal of the American Medical Association (JAMA). The study confirmed that patients who had laparoscopic surgery had the same survival as those who had an open operation (about 81%). 

The Principal Investigator of the study was Professor Andreas Obermair, a gynaecological cancer surgeon at the University of Queensland, and a former Director of the Australian Gynaecological Cancer Foundation. The study was conducted between 2005 and 2010, and involved 760 patients from Australia, New Zealand and Hong Kong. .

Professor Obermaier said: “Substantial short-term benefits for women having a laparoscopic hysterectomy are undisputed. However, we hadn’t known how the survival outcomes of the new operation compared with the traditional abdominal surgical approach until now”.