Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade.

Q2 Medicine Gynecological Surgery Pub Date : 2018-01-01 Epub Date: 2018-02-27 DOI:10.1186/s10397-018-1040-x

Tim Wollinga, Nicole P M Ezendam, Florine A Eggink, Marieke Smink, Dennis van Hamont, Brenda Pijlman, Erik Boss, Elisabeth J Robbe, Huy Ngo, Dorry Boll, Constantijne H Mom, Maaike A van der Aa, Roy F L P Kruitwagen, Hans W Nijman, Johanna M A Pijnenborg

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Abstract

Background: Laparoscopic hysterectomy (LH) for the treatment of early-stage endometrial carcinoma/cancer (EC) has demonstrated to be safe in several randomized controlled trials. Yet, data on implementation of LH in clinical practice are limited. In the present study, implementation of LH for EC was evaluated in a large oncology network in the Netherlands.

Results: Retrospectively, a total of 556 EC patients with FIGO stage I-II were registered in the selected years. The proportion of LH gradually increased from 11% in 2006 to 85% in 2015. LH was more often performed in patients with low-grade EC and was not related to the studied patient characteristics. The introduction of TLH was frequently preceded by LAVH. Patients treated in teaching hospitals were more likely to undergo a LH compared to patients in non-teaching hospitals. The conversion rate was 7.7%, and the overall complication rates between LH and AH were comparable, but less postoperative complications in LH.

Conclusions: Implementation of laparoscopic hysterectomy for early-stage EC increased from 11 to 85% in 10 years. Implementation of TLH was often preceded by LAVH and was faster in teaching hospitals.

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在过去十年中实施子宫内膜癌腹腔镜子宫切除术。

背景：多项随机对照试验已证明腹腔镜子宫切除术（LH）治疗早期子宫内膜癌（EC）是安全的。然而，在临床实践中实施 LH 的数据却很有限。本研究在荷兰的一个大型肿瘤网络中对LH治疗EC的实施情况进行了评估：结果：在所选年份中，共有556名FIGO分期为I-II期的EC患者进行了回顾性登记。LH的比例从2006年的11%逐渐增加到2015年的85%。LH多用于低分化EC患者，与所研究的患者特征无关。在引入TLH之前，往往先进行LAVH。与非教学医院的患者相比，在教学医院接受治疗的患者更有可能接受LH。转化率为7.7%，LH和AH的总体并发症发生率相当，但LH的术后并发症较少：结论：10年间，早期EC腹腔镜子宫切除术的实施率从11%增至85%。TLH通常在LAVH之前实施，在教学医院实施得更快。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Gynecological Surgery SURGERY-

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期刊介绍： "Gynecological Surgery", founded in 2004, is the first and premier peer-reviewed scientific journal dedicated to all aspects of research, development, and training in gynecological surgery. This field is rapidly changing in response to new developments and innovations in endoscopy, robotics, imaging and other interventional procedures. Gynecological surgery is also expanding and now encompasses all surgical interventions pertaining to women health, including oncology, urogynecology and fetal surgery. The Journal publishes Original Research, Reviews, Evidence-based Viewpoints on clinical protocols and procedures, Editorials, Perspectives, Communications and Case Reports.