Endometrial cancer and fibroids: should they be managed laparoscopically?

Abstract

ObjectiveTo describe techniques of morcellation without entry into the uterine cavity and discuss their use in the management of selected patients with endometrial cancer and fibroids.MethodCase series.ResultsEight patients with endometrial cancer arising in a fibroid uterus underwent laparoscopic hysterectomy, and in three cases morcellation was required. The mean uterine weight was 608 g (median 500 g). Four women had pelvic and one had pelvic plus aortic lymphadenectomy in addition to the hysterectomy. One woman had pelvic and another pelvic plus aortic lymph node metastases. The mean age, weight, and body mass index of the patients were 54.8 years, 214 lbs and 36.5, respectively. One nullliparous patient weighed 329 lbs, and another weighed 289 lbs. The mean anaesthetic time was 3.75 h, the mean estimated blood loss 770 ml, and the mean drop in haemoglobin 3.2 g/dl. The mean hospital stay was 2 days, and there were no complications although one patient was transfused.ConclusionsEndometrial cancers arising in a fibroid uterus can be treated laparoscopically in selected cases.