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Geburtshilfe Frauenheilkd 2002; 62(5): 446-451
DOI: 10.1055/s-2002-32287
Originalarbeit

Georg Thieme Verlag Stuttgart · New York

Laparoskopisch-assistierte vaginale versus abdominale Operationstechnik bei Patientinnen mit Endometriumkarzinom - Eine prospektiv randomisierte Studie

Laparoscopic-assisted Vaginal Versus Abdominal Surgery in Patients with Endometrial Cancer - a Prospective Randomized TrialS. Malur1 , I. Steinmetz2 , M. Possover3 , A. Schneider1
  • 1 Abteilung für Frauenheilkunde der Friedrich-Schiller-Universität Jena (Prof. Dr. med. A. Schneider, MPH)
  • 2 Department of Gynecology University Tuscon Arizona, USA
  • 3 Klinik für Frauenheilkunde und Geburtshilfe der Universität zu Köln
Further Information

Publication History

Publication Date:
18 June 2002 (online)

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Zusammenfassung

Fragestellung

Wir vergleichen das laparoskopisch-assistierte vaginale mit dem abdominalen Vorgehen zur operativen Behandlung von Patientinnen mit Endometriumkarzinom.

Patientinnen und Methodik

Im Zeitraum von Juli 1995 bis Mai 2001 wurden 98 Patientinnen mit einem Endometriumkarzinom der FIGO-Stadien I - III prospektiv für den laparoskopisch-assistierten vaginalen oder abdominalen Operationsweg randomisiert.

Ergebnisse

52 Patientinnen wurden der Laparoskopie-, 46 Patientinnen der Laparotomiegruppe zugewiesen. Eine Lymphonodektomie erfolgte bei 36 Patientinnen laparoskopisch und bei 38 Patientinnen im Rahmen der Laparotomie. Ein signifikanter Vorteil des laparoskopisch-assistierten vaginalen Operationsweges konnte für die Parameter Blutverlust, Transfusionsrate, Verlauf der postoperativen Phase und stationäre Verweildauer sowie Langzeitkomplikationen evaluiert werden. Bezüglich Anzahl entfernter Lymphknoten, Operationszeiten, intra- und postoperativen Komplikationen wurden keine Unterschiede zwischen beiden Techniken beobachtet. Rezidivfreies und Gesamtüberleben differierten zwischen beiden Gruppen nicht signifikant.

Schlussfolgerung

Im Vergleich zur konventionellen abdominalen Operationstechnik erreicht man mit laparoskopisch-assistierten vaginalen Operationsverfahren bei der Behandlung des Endometriumkarzinoms eine geringere Morbidität.

Abstract

Purpose

We compared a laparoscopic-vaginal with a conventional abdominal approach for treatment of patients with endometrial cancer.

Patients and Methods

Between July 1995 and May 2001 98 patients with endometrial cancer FIGO stage I - III were randomized to laparoscopic-assisted simple or radical vaginal hysterectomy or simple or radical abdominal hysterectomy with or without lymph node dissection.

Results

52 patients were treated in the laparoscopic versus 46 patients in the laparotomy group. Lymph node dissection was performed in 36 patients by laparoscopy and in 38 patients by laparotomy. Blood loss, transfusion rates, long term complications and duration of hospital stay were significantly lower in the laparoscopic group. Yield of pelvic and para-aortic lymph nodes, duration of surgery, and incidence of intra- and postoperative complications were similar for both groups. Overall- and recurrence-free survival did not differ significantly for both groups.

Conclusion

The laparoscopic-vaginal approach for treatment of endometrial cancer is associated with lower perioperative and long-term morbidity compared with the conventional abdominal approach.

Schlüsselwörter

Laparoskopisch-assistierte vaginale versus abdominale Hysterektomie - Prospektiv randomisierter Vergleich - Endometriumkarzinom - Morbidität - Überleben

Key words

Laparoscopic-assisted vaginal versus abdominal surgery - Prospective randomized comparison - Endometrial cancer - Morbidity - Survival

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Dr. med. Sabine Malur

Abteilung Frauenheilkunde
Friedrich-Schiller-Universität

Bachstraße 18

07740 Jena

Email: Sabine.Malur@med.uni-jena.de