Application and clinical results of minimally invasive surgery based on pathohistological criteria in uterine cancer: A Single Center Study in a Low-income Country

Background: The main objective of this single-center study was to analyze the perioperative complications following minimally invasive surgery (MIS) for uterine cancer, as well as the overall survival and recurrence rate in low-income countries.<br /> Methods: This retrospective study was conducted with the records of 117 endometrial cancer patients who had surgery between 2018 and 2024 were reviewed. Inclusion criteria encompassed both endometrioid and non-endometrioid cancer types, histological grades I-III, and assessment of pelvic and periaortic lymph nodes. Among the patients, 95 underwent laparoscopic pelvic lymph node dissection and hysterectomy. The study excluded 22 women who had laparotomic hysterectomy with dissection of pelvic and aortic lymph nodes.<br /> Results: Ninety-five patients underwent MIS for endometrial cancer. The most common procedures, performed in ninetytwo (96.9%) patients, were TLH, BSO, and BPLND. Sixty-nine (72.6%) patients had a BMI over 30. There were no conversions from laparoscopic surgery (LPS) to laparotomic (LPT). In 65 (68.4%) cases, the procedure took over 120 minutes, and 74 (77.9%) patients had hospital stays of 4 days or less. The longest follow-up was 77 months, with twelve (12.6%) recurrences and an 87.4% (n=83) survival rate.<br /> Conclusion: Our study indicates that LPS is effective for treating uterine-confined endometrial carcinoma, offering comparable lymph node dissection to laparotomy, shorter hospital stays, and fewer postoperative infections for experienced surgeons. While prospective randomized controlled studies are needed to confirm these findings, our results serve as a valuable clinical reference. MIS should be promoted for endometrial cancer treatment, especially in low-income countries.