ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2016
Predictive Factor of Conversion to Laparotomy in Minimally Invasive Surgical Staging for Endometrial Cancer.
Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 18 citations in OpenAlex.
- Real Life Evolution of Surgical Approaches in the Management of Endometrial Cancer in Poland.Cancers · 2025Article
- Conversion from Minimally Invasive Surgical Approaches to Open Surgery Among Patients with Endometrial Cancer in the SGO Clinical Outcomes Registry.Annals of surgical oncology · 2025Article
- Conversion to laparotomy during laparoscopic hysterectomy: a meta-analysis of prevalence and key risk factors.Frontiers in surgery · 2025Article
- Oncologic and Perioperative Outcomes of Robot-Assisted Versus Conventional Laparoscopy for the Treatment of Clinically Uterine-Confined High-Grade Adenocarcinoma.Annals of surgical oncology · 2024Article
- Effects of Minimally Invasive Gynecologic Surgery Subspecialty Training on Outcomes of Hysterectomy for Benign Indications.O&G open · 2024Article
- Association between Obesity, Surgical Route, and Perioperative Outcomes in Patients with Uterine Cancer.Minimally invasive surgery · 2018Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
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Abstract
objectiveThe aim of the study was to identify risk factors associated with laparotomy conversion during total laparoscopic hysterectomy for endometrial cancer.
methodsThis is a retrospective study examining endometrial cancer cases that underwent hysterectomy-based surgical staging initiated via conventional laparoscopic approach. Factors related to patient, tumor, and surgeon were examined to establish risk of laparotomy conversion using a multivariate logistic regression model.
resultsThere were 251 cases identified including 30 cases (12.0%) of laparotomy conversion. The most common indication for laparotomy conversion was a large uterus (27.0%), followed by extensive adhesions (24.3%) and surgical complications (18.9%). Outcomes of cases resulting in laparotomy conversion include longer surgical time (333 vs 224 minutes, P < 0.001), larger blood loss (350 vs 100 mL, P < 0.001), longer hospital stay (4 vs 2 days, P < 0.001), and increased risk of hospital readmission (10% vs 1.4%, P = 0.024). In multivariate analysis, morbid obesity (odds ratio [OR], 4.51; P = 0.011), suboptimal pelvic examination or enlarged uterus during preoperative evaluation (OR, 3.55; P = 0.034), para-aortic lymphadenectomy (OR, 10.5; P = 0.001), uterine size 250 g or greater (OR, 3.49; P = 0.026), and extrauterine disease (OR, 4.68; P = 0.012) remained the independent predictors for laparotomy conversion. The following numbers of risk factors were significantly correlated with laparotomy-conversion rate: none, 1.1%; single risk factor, 5.3% (OR, 5.00; P = 0.15); double risk factors, 21.7% (OR, 24.9; P = 0.002); and triple or more risk factors, 50% (OR, 90.0; P < 0.001). Ultrasonographic 3-dimensional volumes of 496 cm in preoperative uterine size correlate with actual uterine weight of 250 g (Y = 61.5 + 0.38X, P < 0.001).
conclusionsLaparotomy conversion significantly impacts outcomes of patients with endometrial cancer. In this setting, our predictive model for laparotomy conversion will be useful to guide the surgical management of endometrial cancer.
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