Patients prefer laparoscopy to laparotomy

Uterine cancer is the most common cancer of the female reproductive organs. The American Cancer Society estimates that there will be more than 41,000 cases diagnosed this year. Laparotomy, a surgical procedure in which an incision is made in the abdomen, has been the traditional treatment. However, it often causes wound complications, adhesion formation and long hospital stays. A study led by Alice B. Kornblith at Dana-Farber Cancer Institute in Boston found that patients treated by laparoscopy experience a better quality of life compared with those treated by laparotomy.

Laparoscopy involves inserting a slender tube through an incision made in the stomach so that organs of the pelvic area can be examined using small amounts of light. For a study presented in March at the Society of Gynecologic Oncologists’ 37th Annual Meeting on Women’s Cancer in Palm Springs, Calif., 782 patients were randomly assigned to laparoscopy or laparotomy in a clinical trial conducted by the Gynecologic Oncology Group.

All patients were given questionnaires about their quality of life after treatment. Six weeks after surgery, laparoscopy patients reported an overall higher quality of life in terms of pain, physical functioning, resumption of normal activities and a shorter hospital stay, than those who underwent laparotomy. However, after six months, the two groups did not report significant differences in these areas, except for body image, which remained significantly better for laparoscopy patients.

The researchers believe that, because laparoscopy resulted in fewer high-grade (grade 2 and above) postoperative complications and shorter hospital stays and because there was a significant improvement in quality of life six weeks after surgery, it should be considered as a procedure option for patients with uterine cancer.