Comparison of complications and advantages of laparoscopy and laparotomy in endometrial cancer
In a study of 465 patients undergoing laparoscopy and laparotomy, no significant difference was observed between the two procedures in terms of intra or post complications in surgery. In other studies however, laparoscopy reported associated with fewer perioperative complications in the open surgery. Another study suggests intraoperative complications of laparoscopy higher than laparotomy but a lower postoperative complication rate by laparoscopy. Laparoscopy has been reported with laparotomy benefits including lower rates of hemorrhages, fewer hospital days and fewer complications during the procedure, which is why even adults who have been exposed to endometrial cancer may benefit from this method. Possible postoperative complications in people receiving laparoscopy include chest infections and around wound, thrombosis, fever, bleeding, lymphocele and fever patients.
It seems that laparotomy is associated with an increased risk of infection due to a more exposed surgical site and a higher risk of thrombosis and embolism due to a longer postoperative bed rest of laparoscopy. Xu et al. managed to reduce the risk of damage to urology during laparoscopic surgery by filling the salt bladder to improve bladder visualization and by carefully observing the ureter course reduce the risk of accidental injury to the structures.
Laparoscopic and laparotomy approach studies show a significant difference in post operation of the hospital operation, therefore, hospital stay in laparoscopic way is lower than laparotomic. The rate of patients required more than 2 days of hospitalization in a study is less than laparoscopic surgery compared to laparotomy (% 52 versus% 94). Some studies have conducted Study on hospital differences between laparoscopic and robotic approach to older patients and other different age groups did not find a significant difference. Robotic and laparoscopic surgery appears to be more effective in many aspects such as hospital days, blood loss and blood transfusion needs compared to laparotomy and less blood loss and conversion to laparotomy compared to laparoscopy, But as of today, laparotomy is shown to have shorter surgery times than robotic and laparoscopic surgery. Malur et al. 37 endometrial cancer patients underwent laparoscopy and compared them to 33 patients who had laparotomy and found patients in the first group to have shorter hospital days, blood and blood loss transfusion rate. Another study of laparoscopy comparison with laparotomy in patients with endometrial cancer confirmed lower blood loss (145 vs. 501 ml) and hospital stay (2.3 vs 5.5 days) in laparoscopy groups with no difference in the number of lymph nodes removed (21.3 vs. 21.9).
Blood transfusion and blood loss
In a study by Volpi et al. In 77 patients with stage I-III endometrial cancer, patients underwent laparoscopic surgery did not require transfusions and in a study of Scibner et al., patients in the laparoscopy group received more transfusions of the blood rather than the laparotomy group but Bogani et el. who have studied the differences between laparoscopy and laparotomy among women for over 75 years, have not found a substantial difference in blood transfusion rates in two groups. Ghezzi et al. in their study the same
the subject found a higher blood transfusion rate in patients undergoing laparotomy. It is important that studies in different age groups undergo laparoscopy do not show a significant difference in transfusion rates. A study reported that 10.7% of patients undergoing laparoscopic surgery needed blood transfusion while the rate was 14.5% in patients undergoing laparotomy.
Comparison of operation time of laparoscopy versus laparotomy
According to various studies, laparoscopic surgery in endometrial cancer has been much longer than laparotomy. Scribner et al. reported a longer surgical operation for laparoscopic surgery compared to laparotomy in older 65-year-old patients with endometrial cancer. Frigerio et al. reported an average surgery time of 220 min (range 80 to 375) for laparoscopy and 175 min (range of 70 to 360) for laparotomy, while Zullo was found an average of 196.7 for laparoscopy and 135.3 for laparotomy. The portion of the study and experience curve is crucial to the success of a shorter operating time. In a study of laparoscopic approach to endometrial cancer compared to open surgery operations, operative time is longer than a mean of 190 minutes, loss of blood is lower (278.3 ml), hospital stay is shorter, pain medication is lower.