FREE COMMUNICATIONS >>>>>>>>>>> THE LIMITS OF <strong>ENDOSCOPIC</strong> SURGERY B Conclusions: Uterine morcellation is a safe approach to the piecemeal removal an enlarged uterus at time of TLH. Although the uterine morcellation is peformed for larger specimens, it is not associated with longer operating times or greater EBLs. An enlarged uterus alone is not a contra-indication to TLH. We acknowledge that sample sizes are small and therefore p-values are not easily significant. Author address: George S Condous and Alan Lam. Centre for Advanced Reproductive Endosurgery, Royal North Shore Hospital, University of Sydney, Sydney FREE COMMUNICATIONS B LAPAROSCOPIC ONCOLOGY respect to disease free survival with 80% power and · = 0.05. Equivalence will be assumed if the difference in DFS does not exceed 7 per cent at 4 years. Secondary outcomes include treatment related morbidity, postoperative pain and analgesic consumption; costs and cost-effectiveness; patterns of recurrence (date and localisation of first recurrence – local, vault, pelvis, distal); and overall survival. All data from this multicentre study will be entered using online electronic case report forms (e- CRF), allowing real time assessment of data completeness and patient follow-up. Conclusions: The LACE trial will allow to establish the equivalence of a total laparascopic surgical approach for patients with stage 1 endometrial cancer following a two stage protocol to accommodate potential windfalls to patient recruitment. Author address: Andreas Obermair, Val Gebski, Peta Forder, Dan Jackson, Gail Williams and Monika Janda for the LACE Trialists Group Laparoscopic Approach to Carcinoma of the Endometrium (LACE) Friday 18 August / Free Communications B / 1330 - 1340 Obermair A, Gebski V, Forder P, Jackson D, Williams G, Janda M Purpose: Endometrial cancer is the most common gynaecological malignancy in Australia and in other countries of the developed world. Current standard treatment involves open surgery to remove the uterus, and both tubes and ovaries (TAH). The Laparoscopic Approach to Cancer of the Endometrium (LACE) trial was designed and implemented to assess equivalence of performing this in a total laparoscopic approach (TLH). Laparoscopic procedures appeal to patients and patients frequently request to be treated by laparoscopic procedures even if these are not proven to be equivalent. Methods: Patient recruitment for this trial was designed to proceed along two stages to accommodate for a potential increase in patient requests of laparoscopic surgery. During the first stage, patients are randomised in a 2:1 allocation to receive TLH or TAH. The primary endpoint for this stage is quality of life (QoL) at 6 month post-surgery, requiring 180 patients to be enrolled to have 80% power at · = 0.05 to detect a clinically significant difference of 8 points on the Functional Assessment of Cancer General (FACT-G) QoL measurement instruments. If additional recruitment of patients seems impossible after accrual of 180 patients, this cohort will be followed for 4 years, and disease free survival (DFS) of patients treated by TLH will be compared to disease free survival within the population of endometrial cancer patients. During the second stage, recruitment will be extended to a total of 590 patients in a 1:1 TLH: TAH allocation. This sample size will allow to assess the equivalence of these two procedures with Completely total laparoscopic radical hysterectomy for invasive cervical cancer; Initial reports Friday 18 August / Free Communications B / 1340 - 1350 Lee YS, Lee JM, Kim BS, Cho YL, Park IS Objectives: The purposes of this study were to evaluate the surgical outcomes and to discuss the role of completely total laparoscopic radical hysterectomy in the cervical cancer. Methods: Among the 63 patients of cervical cancer patients, forty five patients who underwent total laparoscopic radical hysterectomy between November 2003 and April 2005 in the Kyungpook national university hospital were studied prospectively. Among them, 40 patients had completely total laparoscopic radical hysterectomy (89%), including laparoscopic removal of upper vagina and closure of vaginal stump but five patients needed upper vaginal incision and suturing through vagina (11%). Results: Mean age was 47.2. Mean BMI was 24.1±2.8. FIGO stage were stage 1, 37cases and IIA were 3 cases. Mean operative time was 215.4±51.1 (84-280) minutes and mean blood loss was 186.5±155.3 (40-800) mL. Mean time for laparoscopic closure of vaginal stump was 15.4±5.3 (8-30) min. There was one bladder injury in intraoperative. There were one ileus and one vesicovaginal fistula and 2 vaginal stump infection at the postoperative period. Mean postoperative hospital stay were 8.6±3.1 (5~20) days. Mean self voiding day was 11.4±6.3 (4~29)days. All resected margins were tumor free. The mean number of retrieved pelvic and paraaortic lymph nodes were 26 >>>>>>>> THE LIMITS OF <strong>ENDOSCOPIC</strong> SURGERY
FREE COMMUNICATIONS THE LIMITS OF <strong>ENDOSCOPIC</strong> SURGERY