Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer: A Single-Institution Retrospective Cohort Study

Salvatore Gueli Alletti, Cristiano Rossitto, Stefano Cianci, Stefano Restaino, Barbara Costantini, Francesco Fanfani, Anna Fagotti, Francesco Cosentino, Giovanni Scambia

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Study Objective: To compare the surgical and clinical outcomes of patients affected by early-stage endometrial cancer treated using the Telelap ALF-X platform versus conventional laparoscopic surgery. Design: Single institution retrospective cohort study (Canadian Task Force classification II-2). Setting: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. Patients: The study involved 89 patients affected by early-stage endometrial cancer who underwent elective surgical staging between October 2013 and September 2014. Among them, 43 (48.3%) underwent Telelap ALF-X staging (ALF-X group), and 46 (51.7%) underwent conventional laparoscopic staging (laparoscopic group). Interventions: All selected patients underwent laparoscopic staging with radical hysterectomy (class A sec Querleu-Morrow), bilateral salpingo-oophorectomy, and pelvic lymphadenectomy if required. The 2 surgical groups were further divided into patients who did not require pelvic lymphadenectomy (subgroup 1) and those who underwent pelvic lymphadenectomy (subgroup 2). Measurements and Main Results: In the ALF-X group, the median operative time was 128 minutes (range, 69-260 minutes) for subgroup 1 and 193 minutes (range, 129-290 minutes) for subgroup 2. In the laparoscopic group, the median operative time was 82 minutes (range, 25-180 minutes) in subgroup 1 and 104 minutes (range, 36-160 minutes) in subgroup 2. The difference in operative time between subgroups was statistically significant in both the ALF-X and laparoscopic groups (p =000). In subgroup 1 of the ALF-X group, there was 1 conversion to standard laparoscopy (2.3%) and 2 conversions to laparotomy (4.7%) (p =234). No conversions to laparotomy occurred in the laparoscopic group. Postoperative complications included 1 case of pelvic hematoma (2.3%) in subgroup 1 of the ALF-X group and 1 case of subocclusion and 1 case of pulmonary edema (4.3%) in subgroup 1 of the laparoscopic group. Conclusion: Based on operative outcomes and complication rates, our results suggest that the Telelap ALF-X approach is feasible and safe for endometrial cancer staging; however, further studies are needed to definitively assess the role of Telelap ALF-X early-stage endometrial cancer staging.

Original languageEnglish
Pages (from-to)378-383
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume23
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Endometrial Neoplasms
Laparoscopy
Cohort Studies
Retrospective Studies
Operative Time
Lymph Node Excision
Neoplasm Staging
Laparotomy
Therapeutics
Hospital Obstetrics and Gynecology Department
Ovariectomy
Advisory Committees
Pulmonary Edema
Hysterectomy
Gynecology
Hematoma
Italy

Keywords

  • ALF-X
  • Endometrial cancer
  • Endoscopy
  • Laparoscopy
  • Robotic surgery

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer : A Single-Institution Retrospective Cohort Study. / Gueli Alletti, Salvatore; Rossitto, Cristiano; Cianci, Stefano; Restaino, Stefano; Costantini, Barbara; Fanfani, Francesco; Fagotti, Anna; Cosentino, Francesco; Scambia, Giovanni.

In: Journal of Minimally Invasive Gynecology, Vol. 23, No. 3, 01.03.2016, p. 378-383.

Research output: Contribution to journalArticle

Gueli Alletti, S, Rossitto, C, Cianci, S, Restaino, S, Costantini, B, Fanfani, F, Fagotti, A, Cosentino, F & Scambia, G 2016, 'Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer: A Single-Institution Retrospective Cohort Study', Journal of Minimally Invasive Gynecology, vol. 23, no. 3, pp. 378-383. https://doi.org/10.1016/j.jmig.2015.11.006
Gueli Alletti, Salvatore ; Rossitto, Cristiano ; Cianci, Stefano ; Restaino, Stefano ; Costantini, Barbara ; Fanfani, Francesco ; Fagotti, Anna ; Cosentino, Francesco ; Scambia, Giovanni. / Telelap ALF-X vs Standard Laparoscopy for the Treatment of Early-Stage Endometrial Cancer : A Single-Institution Retrospective Cohort Study. In: Journal of Minimally Invasive Gynecology. 2016 ; Vol. 23, No. 3. pp. 378-383.
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abstract = "Study Objective: To compare the surgical and clinical outcomes of patients affected by early-stage endometrial cancer treated using the Telelap ALF-X platform versus conventional laparoscopic surgery. Design: Single institution retrospective cohort study (Canadian Task Force classification II-2). Setting: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. Patients: The study involved 89 patients affected by early-stage endometrial cancer who underwent elective surgical staging between October 2013 and September 2014. Among them, 43 (48.3{\%}) underwent Telelap ALF-X staging (ALF-X group), and 46 (51.7{\%}) underwent conventional laparoscopic staging (laparoscopic group). Interventions: All selected patients underwent laparoscopic staging with radical hysterectomy (class A sec Querleu-Morrow), bilateral salpingo-oophorectomy, and pelvic lymphadenectomy if required. The 2 surgical groups were further divided into patients who did not require pelvic lymphadenectomy (subgroup 1) and those who underwent pelvic lymphadenectomy (subgroup 2). Measurements and Main Results: In the ALF-X group, the median operative time was 128 minutes (range, 69-260 minutes) for subgroup 1 and 193 minutes (range, 129-290 minutes) for subgroup 2. In the laparoscopic group, the median operative time was 82 minutes (range, 25-180 minutes) in subgroup 1 and 104 minutes (range, 36-160 minutes) in subgroup 2. The difference in operative time between subgroups was statistically significant in both the ALF-X and laparoscopic groups (p =000). In subgroup 1 of the ALF-X group, there was 1 conversion to standard laparoscopy (2.3{\%}) and 2 conversions to laparotomy (4.7{\%}) (p =234). No conversions to laparotomy occurred in the laparoscopic group. Postoperative complications included 1 case of pelvic hematoma (2.3{\%}) in subgroup 1 of the ALF-X group and 1 case of subocclusion and 1 case of pulmonary edema (4.3{\%}) in subgroup 1 of the laparoscopic group. Conclusion: Based on operative outcomes and complication rates, our results suggest that the Telelap ALF-X approach is feasible and safe for endometrial cancer staging; however, further studies are needed to definitively assess the role of Telelap ALF-X early-stage endometrial cancer staging.",
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N2 - Study Objective: To compare the surgical and clinical outcomes of patients affected by early-stage endometrial cancer treated using the Telelap ALF-X platform versus conventional laparoscopic surgery. Design: Single institution retrospective cohort study (Canadian Task Force classification II-2). Setting: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. Patients: The study involved 89 patients affected by early-stage endometrial cancer who underwent elective surgical staging between October 2013 and September 2014. Among them, 43 (48.3%) underwent Telelap ALF-X staging (ALF-X group), and 46 (51.7%) underwent conventional laparoscopic staging (laparoscopic group). Interventions: All selected patients underwent laparoscopic staging with radical hysterectomy (class A sec Querleu-Morrow), bilateral salpingo-oophorectomy, and pelvic lymphadenectomy if required. The 2 surgical groups were further divided into patients who did not require pelvic lymphadenectomy (subgroup 1) and those who underwent pelvic lymphadenectomy (subgroup 2). Measurements and Main Results: In the ALF-X group, the median operative time was 128 minutes (range, 69-260 minutes) for subgroup 1 and 193 minutes (range, 129-290 minutes) for subgroup 2. In the laparoscopic group, the median operative time was 82 minutes (range, 25-180 minutes) in subgroup 1 and 104 minutes (range, 36-160 minutes) in subgroup 2. The difference in operative time between subgroups was statistically significant in both the ALF-X and laparoscopic groups (p =000). In subgroup 1 of the ALF-X group, there was 1 conversion to standard laparoscopy (2.3%) and 2 conversions to laparotomy (4.7%) (p =234). No conversions to laparotomy occurred in the laparoscopic group. Postoperative complications included 1 case of pelvic hematoma (2.3%) in subgroup 1 of the ALF-X group and 1 case of subocclusion and 1 case of pulmonary edema (4.3%) in subgroup 1 of the laparoscopic group. Conclusion: Based on operative outcomes and complication rates, our results suggest that the Telelap ALF-X approach is feasible and safe for endometrial cancer staging; however, further studies are needed to definitively assess the role of Telelap ALF-X early-stage endometrial cancer staging.

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