7490 Perioperative Outcomes of the "Chopsticks Technique" Single-Site Laparoscopy Versus Traditional Laparoscopy for Endometrial Cancer

Abstract

<h3>Study Objective</h3> To describe the new "chopsticks technique" single-site laparoscopic surgery technology and to compare the perioperative outcomes of the new "chopsticks technique" laparoendoscopic single-site surgery (LESS) versus traditional laparoscopic surgery (TLS) in the staging surgery of endometrial cancer (EC). <h3>Design</h3> Retrospective case-control study based on propensity score matching (PSM). <h3>Setting</h3> Department of gynecology at a tertiary medical center. <h3>Patients or Participants</h3> From August 2018 to August 2020 at Southwest Hospital in Chongqing, China, patients diagnosed with endometrial cancer, a total of 26 cases conducted LESS were matched with a cohort of 52 cases who underwent TLS. <h3>Interventions</h3> A propensity score matching was performed to reduce the bias due to the imbalanced baseline features between the two groups, and the perioperative outcomes were compared between matched cohorts. <h3>Measurements and Main Results</h3> We retrospectively reviewed 535 cases of patients diagnosed with endometrial cancer from our institutional database. A 1:2 propensity score matching was conducted matched by age, BMI, history of surgery, FIGO staging between the two groups. After matching, the variables were well balanced with no differences at baseline between groups. The operations in both groups were successfully completed without conversion to laparotomy. There were no statistically significant differences in the amount of intraoperative blood loss, number of lymph nodes removed, postoperative exhaust time, postoperative indwelling drainage time, postoperative hospital stay, etc. between the two groups (P>0.05). Meanwhile, compared with the TLS group, the LESS group has longer operation time, a lower pain score of 24-hour after surgery and a more satisfactory postoperative cosmetic effect, of which the difference was statistically significant (P <0.05). <h3>Conclusion</h3> It is undoubtedly safe and feasible for staging endometrial cancer to employ the "chopsticks technique" single-site laparoendoscopic with minimum scars from abdominal incisions, which results less pain and outstanding cosmetic effects. However, further prospective, randomized studies with larger samples are needed.