Table 4. Perioperative morbidity and estimated cost in euros of lymphadenectomy for IREC.
| Characteristics | Lymphadenectomy (n=178) | No lymphadenectomy (n=178) | p-value* | ||
|---|---|---|---|---|---|
| Surgical time (min) | 140.0 (80–330) | 99.5 (40–200) | <0.001 | ||
| Estimated blood loss (mL) | 210.0 (45–1,000) | 200.0 (60–600) | 0.249 | ||
| Drop of hemoglobin (g/dL) | 2.1 (0.4–4.9) | 1.8 (0.1–7.8) | 0.056 | ||
| Transfusion rate | 6 (3.4) | 10 (5.6) | 0.306 | ||
| Surgical morbidity† | 37 (20.8) | 44 (24.7) | 0.376 | ||
| Length of hospital stays (day) | 7.0 (2–33) | 7.0 (1–30) | 0.352 | ||
| Overall complications | 36 (20.2) | 48 (26.9) | 0.134 | ||
| Intraoperative | 6 (3.4) | 9 (5.1) | 0.429 | ||
| Bowel/ureter injury | 2 | 1 | >0.999 | ||
| Vascular injury | 4 | 1 | 0.371 | ||
| Bowel injury | 0 | 3 | 0.248 | ||
| Early postoperative | 30 (16.9) | 39 (21.9) | 0.227 | ||
| Clavien-Dindo classification | 0.548 | ||||
| I–II | 22 | 31 | |||
| III–IV | 8 | 8 | |||
| Type of complication | |||||
| Infections‡ | 12 | 24 | 0.035 | ||
| Vaginal cuff dehiscence | 2 | 0 | 0.498 | ||
| Thromboembolic disease | 2 | 1 | >0.999 | ||
| Ileus | 6 | 4 | 0.750 | ||
| Heart/renal insufficiency | 1 | 2 | >0.999 | ||
| Hematoma | 5 | 6 | >0.999 | ||
| Other§ | 2 | 2 | >0.999 | ||
| Late postoperative | 9 (5.1) | 1 (0.6) | 0.019 | ||
| Lymphocyst | 2 | 0 | 0.498 | ||
| Lower-limb lymphedema | 7 | 1 | 0.067 | ||
| Readmittance | 8 (4.5) | 8 (4.5) | >0.999 | ||
| Reintervention | 7 (3.9) | 6 (3.4) | >0.999 | ||
| Cost in euros | |||||
| Surgical cost∥ | 1,223.3 (427.0–4,803.4) | 1,116.8 (417.2–4,453.1) | 0.624 | ||
| Hospitalization cost¶ | 3,063.3 (1,120.4–17,413.4) | 3,546.3 (635.2–14,308.7) | 0.665 | ||
| Global cost** | 4,710.7 (2,049.5–11,686.7) | 4,438.7 (2,047.2–13,684.4) | 0.217 | ||
Data are shown as median (range) or cases (%).
LDN, lymph node dissection; IREC, intermediate-risk endometrial cancers.
*The t-test in variables with normal distribution, Mann-Whitney test for the others continuous variables and χ2 test or Fisher's test in discrete variables. †Surgical morbidity was defined as presence of one or more of the following situations: transfusion, estimated blood loss >400 mL, surgical time >240 minutes or intraoperative complication. ‡Infection includes wound, urinary and/or, respiratory infections, and isolated fever. §Other complications include in LDN group a glycemic decompensation, hypertensive encephalopathy; and in no-LDN group acute psychosis and digestive hemorrhage. ∥Surgical cost include cost of technical recourses (7 years of amortization), personal, instruments used, cost of operating room, complications, and conversions to others surgical approaches. ¶Hospitalization cost include days of hospital stay, complications, transfusions, and need of unit care. **Global cost include all cost measured.