Feasibility of minimally invasive surgery with implementation of ERAS protocol versus traditional laparotomy in the management of early-stage endometrial cancer | ||||
Minia Journal of Medical Research | ||||
Volume 30, Issue 1, March 2019, Page 94-100 PDF (271.51 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/mjmr.2022.222789 | ||||
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Authors | ||||
Ahmad S. Sanad1; Essam El- Gindi1; Ahmed S. Hafiz2; Reham R. El- Khateeb1; Ahmed M. Abd El- Ghany1; Ahmed B. Mousa1 | ||||
1Department of Obstetrics and Gynecology, Faculty of medicine, Minia University | ||||
2Department of oncology and general surgery, El Salam Oncology centre, Cairo | ||||
Abstract | ||||
Background: It has been suggested that the laparoscopic approach is associated with a reduction in operative morbidity. Over the last two decades there has been a steady increase in the use of laparoscopy for endometrial cancer. This review investigated the evidence of benefits and harms of laparoscopic surgery with implementation of ERAS program, versus traditional laparotomy for presumed early stage endometrial cancer. Study objective: To study the efficacy of laparoscopic radical hysterectomy with implementation of ERAS protocol for treatment of endometrial cancer on operative outcome and overall survival in comparison with traditional abdominal hysterectomy. Selection criteria: Non randomized controlled trial comparing laparoscopy with ERAS and laparotomy with mechanical bowel preparation for treatment of early stage endometrial cancer. Data collection and analysis: The study was done in El- Salam Oncology center, Cairo and Minia maternity university hospital (MMUH), Egypt. The study included two groups of patients diagnosed as endometrial carcinoma ( stage I) prepared for operations. First group (27 patients ) managed with laparoscopy with implementation of ERAS protocol while the other group (31 patients) managed with conventional laparatomy. Results: There was statistically significant reduction in action group than in conventional group as regarding : LOS (2.15 + 0.71 Vs 0.39+ 0.80), reduction in post operative pain which assessed by VAS score ( 3.04 +1.05) vs ( 5.71 + 1.00) and post operative fluid balance (916.67 ml) vs ( 2345.16 ml). There was statistically insignificant difference between both groups in postoperative pneumonia, urinary tract infection, surgical site infection. As a result readmission to hospital was less in active group than conventional (2 vs 8patients). Conclusion: Implementation of ERAS protocol in gynecologic surgery for endometrial carcinoma tailored according to the situation in each case, But in general; use of laparoscopy with ERAS was associated with controlled intravenous fluids utility, comparable pain, better operative outcome with less complication rates compared to conventional laparotomy. | ||||
Keywords | ||||
Enhanced recovery after surgery (ERAS) endometrial carcinoma(EC); length of hospital stay (LOS) | ||||
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