Evaluation of Laparoscopic Staging Versus Staging Laparotomy for Early Stage Endometrial Cancer

Primary Outcome: perioperative morbidities:

• intraoperative complications like bladder injury, ureteric injury, vascular injury & bowel injury.
• Early postoperative complications like paralytic ileus, postoperative fever ((defined as a temperature higher than 38 c on two consecutive postoperative days or higher than 39 c on any postoperative day).

Secondary outcomes:

• Amount of blood loss by allowable blood loss formula between conventional staging laparotomy and laparoscopic staging & need for blood transfusion. (ABL = weight kg * age sex factor (65ml/ kg) *initial HGB(g/dl)-final HGB(g/dl) / initial HGB (g/dl) (Jaramillo, 2019).
• oncological outcomes (one-year survival rate, need for adjuvant chemo or radiotherapy, recurrent rate after one year) indicate radical malignancy elimination.
• Operation time from skin to skin in hours.
• ICU admission.
• Wound infection.
• Hospital stays in days.
• A post-operative pain person rates their pain on a scale of 0 to 10. Zero means "no pain," and 10 means "the worst possible pain. Laparoscopic surgical staging operation is a safe and effective therapeutic procedure for the management of endometrial cancer especially lymphadenectomy with acceptable morbidity and radical treatment to the malignancy compared to the laparotomy.

Inclusion criteria

• Inclusion Criteria:

I. Patient histopathological diagnosed early-stage endometrial carcinoma, (stages 1A &1B) according to FIGO classification.

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Exclusion criteria

• Exclusion Criteria:

• The patient received neoadjuvant chemo or radiotherapy.
• The presence of ovarian tumors, and proven metastasis outside the uterus.
• The presence of any contraindication for general anesthesia like heart failure, myocardial infarction, unstable angina, or COPD, poorly controlled or contraindication of Trendelenburg position for a long duration; marked hip disease preventing the usage of the dorsal lithotomy position.
• Cases with evidenced advanced stage of the neoplasm clinically and radiologically according to the routine pre-operative investigations.