Local treatment of gynaecological cancer featuring surgical staging, lymphadenectomy and LAVH (Laparoscopic Assisted Vaginal Hysterectomy) in stage I endometrial cancer

Abstract

The role of surgery in the treatment of patients with invasive cervical cancer is undisputed, but how radical the surgery should be is discussed. Every case requires detailed knowledge of the development and spread of cervical cancer. Tumour volume is the most important diagnostic factor in cervical cancer and also correlates with vascular invasion and lymph node involvement. In cervical cancer radical hysterectomy also requires an easily performable lymphadenectomy together with resection of parametria and skeletonization of ureters. In order to do this we have started to treat endometrial cancer in a combined laparoscopic and vaginal approach. In patients with the suspicion of stage I endometrial cancer prior to the laparoscopic staging, the prerequisites histological grading with ploidy and measurement of monoclonal antibodies were performed. All patients underwent a general check with radiography, computer tomography, liver scan, bone scan and lymphography. The performance of lymphadenectomy in cases of stage I endometrial cancer remains a controversial subject [1, 2]. We believe that laparoscopic assisted surgical staging of stage I endometrial cancer is an attractive alternative to the traditional laparotomy-surgical approach. The change from laparotomy to the laparoscopic assisted vaginal approach results in a similar success rate with the less invasive approach. No complications occurred in this series and the results of our pilot study were satisfactory.

Key Words:

• stage I endometrial cancer
• laparoscopic lymphadenectomy
• laparoscopic assisted vaginal hysterectomy