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Journal

Comparison of laparoscopy and laparotomy for endometrial cancer

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Published:25th Mar 2020
Objective: To compare the safety and efficacy of laparoscopy and laparotomy on clinical outcomes among patients with endometrial cancer. Methods: Eligible randomized controlled trials (RCTs) conducted between 1966 and June 2010 were analyzed by meta-analysis. Results: Eight RCTs were included, with 3599 patients in total. No significant difference was observed between laparoscopy and laparotomy in overall (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.50�1.82; P=0.892), disease-free (OR, 0.96; 95% CI, 0.50�1.82; P=0.892), or cancer-related (OR, 0.90; 95% CI, 0.27�3.08; P=0.871) survival. More intraoperative complications (OR, 1.33; 95% CI, 1.03�1.73; P=0.030), fewer postoperative complications (OR, 0.59; 95% CI, 0.46�0.75; P<0.001), longer operative time (standardized mean difference [smd], 0.80; 95% ci, 0.46�1.15; p><0.001), lower blood loss (smd, �2.29; 95% ci, �3.67 to ?0.91; p="0.001)," and shorter hospital stay (smd, �2.60; 95% ci, �3.47 to ?1.72; p><0.001) were associated with laparoscopy. there was no significant difference between the groups in pelvic (smd, 0.22; 95% ci, �0.03 to 0.48; p="0.086)" or para-aortic (smd, 0.54; 95% ci, �0.04 to 1.11; p="0.067)" lymph node yield. conclusion: laparoscopy has short-term advantages and seemingly equivalent long-term outcomes and, in experienced hands, might be a feasible alternative to laparotomy for endometrial cancer.>

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