Abstract
PURPOSE:
The purpose of this study was to evaluate the feasibility and safety of 2-port access (TPA) laparoscopy in gynecologic oncology.
METHODS:
This
was a retrospective review of 81 consecutive patients who underwent TPA
laparoscopic surgery for various gynecologic cancers from March 2009 to
September 2011. The TPA system consisted of a single multichannel port
at the umbilicus and an ancillary 5-mm port in the suprapubic area.
RESULTS:
The surgical procedures included comprehensive ovarian cancer staging (33 patients), radical hysterectomy with pelvic lymph node dissection (19 patients), and endometrial cancer
staging (29 patients). All surgical procedures were completed
laparoscopically with no conversion to laparotomy. Two cases required 1
or 2 additional ports. The mean operating time, estimated blood loss,
and number of lymph nodes were 253.8 minutes, 170.7 mL, and 34.9,
respectively. Three patients (9.1%) with ovarian cancer and 4 patients (13.8%) with endometrial cancer
were upstaged after surgery. The mean postoperative hospital stay was
6.6 days, and the mean postoperative pain scores (0-10 scale) were 3.4
at 6 hours, 3.0 at 24 hours, and 2.5 at 48 hours. Postoperative
complications occurred at a low incidence (4.9%) and included one
umbilical hernia, one vault dehiscence, and one lumbosacral nerve
injury.
CONCLUSIONS:
Two-port access laparoscopic surgery
using a single multichannel port system is a feasible and safe
procedure in selected patients with gynecologic cancers. Prospective
randomized trials will permit the evaluation of the potential benefits
of this minimally invasive surgical technique.
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