Perioperative Outcomes of the New Chopsticks Technique Single-Site Versus Traditional Laparoscopy in the Staging of Endometrial Cancer

Abstract

<h3>Study Objective</h3> To describe the new"chopsticks technique"single-site laparoscopic surgery technique, and compare the Perioperative outcomes of "chopsticks technique" single-site laparoscopy versus traditional laparoscopy for endometrial cancer. <h3>Design</h3> A retrospective case-control study based on propensity score matching. <h3>Setting</h3> Department of gynecology at a tertiary medical center. <h3>Patients or Participants</h3> From August 2018 to August 2020, a total of 78 patients who accepted the laparoscopic staging of endometrial cancer were retrospectively analyzed. 26 cases conducted "chopsticks technique"single-site laparoscopic surgery(LESS) were matched with a cohort of 52 cases who underwent traditional multi-site laparoscopic surgery (CLS). <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> A retrospective case–control study was conducted matched by age, BMI, history of surgery, FIGO staging. 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, pelvic lymph nodes, number of para-aortic lymph nodes removed, postoperative exhaust time, postoperative indwelling drainage time, postoperative hospital stay between the two groups (P>0.05). Meanwhile, Compared with the traditional multi-port laparoscopic group CLS, the "chopsticks technique" single-site laparoscopic group (LESS) has longer operation time (197.3±55.7 vs. 164.7±62.7, p=0.043) , a pain score of 24-hour after surgery (3 (3,2) vs3 (4,2) , p=0.031) and a more satisfactory postoperative cosmetic effect (6.9±0.5 vs. 6.12±0.7, p=0.023) , of which the difference was statistically significant (P <0.05). <h3>Conclusion</h3> It is safe and feasible for staging endometrial cancer to employ the"chopsticks technique"single-site laparoscopic with minimum scars from abdominal incisions, which results in less pain and outstanding cosmetic effects. However, further prospective, randomized studies with larger samples are needed.