Page 7 - WALS Journal

WJOLS

10.5005/jp-journals-10033-1163
REVIEW ARTICLE Laparoendoscopic Single-Site Surgery in Gynecologic Oncology
Laparoendoscopic Single-Site Surgery in

Gynecologic Oncology

Mohammed Khairy Ali, Ahmed Yehia Abdelbadee, Ahmed Mohammed Abbas, Sherif Abdel-Karim Mohammed Shazly

ABSTRACT elective oophorectomy and risk-reducing oophorectomy.
Finally, LESS for ovarian and endometrial cancer.
Objective: To provide a review in the available literature in
laparoendoscopic single site surgery in gynecological oncology,
focusing on epidemiology of ovarian and endometrial cancer in EPIDEMIOLOGY OF OVARIAN CANCER IN
reproductive age, role of minimally invasive surgery in the REPRODUCTIVE AGE
management of ovarian and endometrial cancer and
laparoendoscopic single site surgery elective oophorectomy and In gynecologic oncology, ovarian cancer leads to more
risk-reducing oophorectomy. Finally, laparoendoscopic single- deaths than all other gynecologic malignancies. Each year
site surgery for ovarian and endometrial cancer. about 204,000 women are diagnosed with ovarian cancer
3
Design: Literature survey. but only 125,000 women die from this disease. The
Conclusion: Laparoscopy is a safe and effective approach for incidence of ovarian cancer is about one in 78 American
surgical staging and treatment of selected patients with women (1.3%) that can develop ovarian cancer during her
endometrial and ovarian cancer. Further studies and analyses lifetime. But the incidence has been declining slowly since
are required to determine if the use of robotics improves
outcomes over standard laparoscopy and can extend the 1990. The epithelial ovarian carcinomas consider the most
benefits of minimally invasive surgery to a larger proportion of common one which represent about 90 to 95% of all cases.
patients with this common gynecologic malignancy. In general, the diagnosis of ovarian cancer is difficult
Keywords: Single-port laparoscopy, Robotic surgery, because the symptoms of ovarian cancer are vague and
Gynecologic oncology. related mainly to GIT system and there is no effective
How to cite this article: Ali MK, Abdelbadee AY, Mohammed screening test for ovarian cancer, so most of the patients
Abbas A, Abdel-Karim Mohammed Shazly S. Laparoendoscopic have advanced disease when they are diagnosed and need
Single-Site Surgery in Gynecologic Oncology. World J Lap Surg usually aggressive debulking surgery followed by
2012;5(3):121-127.
chemotherapy which usually results in clinical remission,
Source of support: Nil but about 80% of women will develop recurrence that leads
Conflict of interest: None to disease progression and death.
In 2007, there were 22,430 cases which estimated to
INTRODUCTION develop in the United States. However, the early diagnosis
Minimally invasive surgery has become the gold standard is still strict only to a few cases, so the ovarian cancer is
treatment for many gynecologic diseases. In the past, still the fifth leading cause of cancer-related death. 4
numerous studies have demonstrated that laparoscopic Numerous risk factors are associated with the
surgery plays an important role in various gynecologic development of ovarian cancer including reproductive,
oncologies particularly for early-stage endometrial, ovarian environmental and genetic risk factors but the most
and cervical cancers with shorter hospital stays, improved important risk factor is a family history of ovarian cancer
quality of life and comparable surgical and oncologic and breast cancer because there are about 5 to 10% of
1
outcomes to laparotomy. Recently, an even less invasive patients having an inherited genetic predisposition, but still
alternative to conventional laparoscopy has been developed: 90 to 95% have no genetic link for ovarian cancer. Many
Laparoendoscopic single-site surgery (LESS) which is an risk factors are related to a pattern of ovarian cycles during
attempt to further enhance the cosmetic benefits of the reproductive years, so repeated stimulation of the surface
minimally invasive surgery while minimizing the potential epithelium of the ovary will lead to malignant transformation
morbidity associated with multiple incisions. LESS is later on. Also the parity of the female plays an important
applied to urologic and gastrointestinal surgery firstly and role in development of ovarian cancer because the nulliparity
2
demonstrates that the techniques are feasible. In this review is usually associated with long periods of repetitive
article, we review the available literature about role of LESS ovulation, and also women without children have double
5
in management in gynecological malignancies, focusing on the risk of developing ovarian cancer. Women who have
epidemiology of ovarian and endometrial cancer in long period of infertility have a higher risk for ovarian
reproductive age, role of minimally invasive surgery in the cancer. Although the genetic link of ovarian cancer is very
management of ovarian and endometrial cancer and LESS high but also the iatrogenic effect of the drugs used in
World Journal of Laparoscopic Surgery, September-December 2012;5(3):121-127 121