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Total Laparoscopic Hysterectomy for Endometrial Cancer

Total Laparoscopic Hysterectomy for Endometrial Cancer. Andreas Obermair RBWH & Greenslopes Private Hospital www.obermair.info. Total Lap Hysterectomy (TLH). Operation entirely laparoscopic Not LAVH Feasible and safe in obese and in nulliparous patients. Feasibility @ 170 kg.

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Total Laparoscopic Hysterectomy for Endometrial Cancer

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  1. Total Laparoscopic Hysterectomy for Endometrial Cancer Andreas Obermair RBWH & Greenslopes Private Hospital www.obermair.info

  2. Total Lap Hysterectomy (TLH) • Operation entirely laparoscopic • Not LAVH • Feasible and safe in obese and in nulliparous patients

  3. Feasibility @ 170 kg

  4. Morphine consumption (mg) P<0.0001

  5. Non-Steroidal Analgesics (days) P<0.0001

  6. Laparoscopy & Endometrial Cancer Case reports of port-site metastasis Is TLH safe for cancer patients ??

  7. Results • TLH n=226 • TAH n=284 • Conversion in 11 patients (4.8%) • Follow-up 30 months Obermair et al, Gynecol Oncol 2004

  8. Patients TLH younger, heavier, higher ASA score, more likely early-stage. Obermair et al, Gynecol Oncol 2004

  9. Prognosis • Disease-free survival @ 5 years • 85.5% • Recurrences • 9 of 226 TLH (4.0%) • 37 of 248 TAH (14.9%) • Overall survival @ 5 years • 77.5% Obermair et al, Gynecol Oncol 2004

  10. Patterns Recurrence Obermair et al, Gynecol Oncol 2004

  11. Prognostic Factors • Age • Stage • Grade • Depth of myometrial invasion • Mode of Treatment was NOT of prognostic significance Obermair et al, Gynecol Oncol 2004

  12. Survival Curve TLH TAH n.s.

  13. Summary 1 1. TLH successfully completed even in morbidly obese and nulliparous patients (failed in 5%). 2. Pain & Analgesic consumption minimal 3. Hospital Stay reduced to 2 to 3 days

  14. Summary 2 3. Safety: • No mortality • Adverse events (wound infection) dramatically reduced 4. Patterns of recurrence and survival - similar

  15. Thanks for listening www.obermair.info

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