Publication:

Total laparo-endoscopic single site surgery hysterectomy for endometrial cancer: a single-centre retrospective review

Background LESS surgery is a novel technique for benign gynaecological conditions. It has advantages of shorter operative stay, less post-operative pain, better cosmesis, and improved patient satisfaction. However, similar data is limited in endometrial cancer. This study aims to analyse the peri- and post-operative outcomes of LESS surgery for endometrial cancer.

Methods This was a retrospective, single-centre study. One gynae-oncologist trained in minimally invasive surgery performed 97 cases of LESS surgery for endometrial cancer at Singapore General Hospital, Singapore from January 2018 to December 2023.

Results 97 patients were recruited for this study. At the time of pre-operative staging, 72 women were Stage IA, and 22 IIB. All underwent total hysterectomy bilateral salpingo-oophorectomy, with 90 and three patients undergoing pelvic and para-aortic lymphadenectomy respectively. A median of 18 pelvic lymph nodes (IQR 13-21) were retrieved. The median operative time and operative blood loss was 165 minutes (IQR 130-196.25) and 100mls (IQR 50-150) respectively. The median hospitalization stay was 2 days (range 1-7). Two women were readmitted for ileus (POD20) and post-op fever secondary to urinary tract infection (POD14), both of which were managed conservatively. The median duration of follow up was 24.5 months. There was 1 reported case of recurrence. There were three deaths in this study.

Conclusions Women with early-stage endometrial cancer should be offered LESS surgery. It is a safe and effective surgical option for the management of endometrial carcinoma.