Comparison of single-port laparoscopy and laparotomy in early ovarian cancer surgical staging

Abstract

ObjectivesThe aims of this study were to assess the feasibility of single-port laparoscopic surgical staging (SPLS) in early ovariancancer and to compare the surgical outcomes of SPLS with those of staging laparotomy. MethodsBetween January 2014 and December 2018, 40 patients underwent SPLS and 41 patients underwent staginglaparotomy at Yonsei Cancer Center. The patients were diagnosed with International Federation of Gynecology andObstetrics (FIGO) stage I ovarian cancer. Variables such as patient age, body mass index (BMI), tumor size, FIGO stage,and perioperative surgical outcomes and survival outcomes of SPLS and laparotomy were compared. ResultsThe total operation time was similar between the 2 groups (SPLS: 201.4 vs. laparotomy: 203.0 minutes, P=0.806). Themedian tumor diameters in the SPLS and laparotomy groups were 11.0 (2.5–28 cm) and 15.4 (6–40 cm), respectively(P=0.001). The SPLS group had lower tumor spillage rate (5.0% vs. 19.5%, P=0.047), less intraoperative blood loss (102.0vs. 371.5 mL, P<0.001), less postoperative pain, and shorter postoperative hospital stay (5 vs. 9.5 days, P<0.001). Theintraoperative major complication rate was similar between groups (2.5% vs. 4.9%, P=0.571). There was no significantdifference in progression-free survival between the 2 groups (P=0.945). There were no deaths in either group. ConclusionSPLS is feasible in early ovarian cancer and has better perioperative surgical outcomes, in some aspects, than staginglaparotomy without compromising survival outcomes. SPLS could be performed in patients suspected to have earlyovarian cancer.