الفهرس | Only 14 pages are availabe for public view |
Abstract Contemporary management for most patients with (EC) remains surgical. Traditionally an open abdominal approach has been the treatment of choice with total hysterectomy and BSO with or without lymphadenectomy. The use of laparoscope as a surgical approach in these cases is feasible and has many advantages over TAH with few limitations. The success in the current study is attributed mainly to the use of minimally invasive surgery and strict implementation of ERAS protocol. Conclusions: Complete surgical staging and treatment of (E.C.) can be performed using laparoscopy as an alternative to routine open method with similar efficacy regarding nodal retrieval, better operative and postoperative compliance in means of blood loss , ileus and length of hospital stay. Implementation of ERAS protocol allows early enteral intake, early regain of bowel motility ,early ambulation and shortening of hospital stay without increase in postoperative complications. Recommendations: 1. Selection of surgical approach according to definitive preoperative diagnosis ,availability of instrumentations and presence of experienced hands 2. Although lymphadenectomy in clinical stage I endometrial cancer decreases recurrence , it has no impact on overall or relapse free survival . In the clinic, lymphadenectomy should be performed for staging only in high risk cases. There is little evidence to support a therapeutic benefit, but it may be used to select women with positive nodes for adjuvant therapy. 3- The current study recommends the use of laparoscopy in staging and management of endometrial cancer with strict implementation of ERAS protocol if available infrastructure instrumentations and experienced hands. |