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Laparoscopy in the treatment of endometrial cancer – description of surgical technique

Piotr Sobiczewski, Mariusz Bidziński

Affiliacja i adres do korespondencji
GIN ONKOL, 2004, 2 (2), p. 107-113
Streszczenie

The objective was to present the current laparoscopic technique used in the surgery of endometrial cancer. Endometrial cancer is the second common malignancy of the female genital tract in Europe. In 80% of cases the disease is limited to the uterus and the stage I according to FIGO classification is recognized. Surgery is the cornerstone of treatment and since 1989 FIGO recommend the surgico-pathologic classification based on operative protocol. The traditional approach in endometrial cancer was laparotomy. The combined vaginal and laparoscopic method to remove uterus and lymph nodes was introduced since 1992. Material and methods: Laparoscopy for the surgical treatment of patients with endometrial cancer in Gynecologic Oncology Department in Warsaw was introduced since 1994. The pelvic and obturator lymphadenectomies were performed by transperitoneal approach described by Querleu. Hysterectomies were performed with LAVH or TLH. The indications for LAVH were: good vaginal access and in multiparity. The laparoscopic part of operation comprised lymphadenectomy and coagulation of infundibulo-pelvic ligaments. Total laparoscopic hysterectomy was performed in patients with narrow vagina and bad vaginal access. In TLH, lymphadenectomy and hysterectomy with coagulation of uterine vessels were performed laparoscopically. Conclusion: LAVH and TLH with lymphadenectomy may be performed in selected cases of endometrial cancer. The both techniques should be applied according to the indications and anatomical conditions.

Słowa kluczowe
endometrial cancer, laparoscopic lymphadenectomy, LAVH, TLH