Laparoscopic vs. open surgery for early-stage endometrial cancer: effect on inflammatory factors and quality of life.

OBJECTIVE

To evaluate the differential effects of laparoscopic versus open surgery on inflammatory factors and quality of life (QoL) in patients with early-stage endometrial cancer (EEC).

METHODS

A total of 165 eligible EEC patients treated between January 2023 and June 2025 were enrolled and stratified according to surgical schemes into a control group (n=80; open surgery) and a research group (n=85; laparoscopic surgery). Comparative analyses were conducted across multiple domains, including therapeutic efficacy, safety outcome (e.g., incision infection, intestinal injury, ureteral injury, lower-limb deep venous thrombosis, and urinary retention), surgical indicators (intraoperative blood loss, operation time, lymph node yield), postoperative recovery (time to intestinal function recovery, duration of bed rest, and length of hospital stay), bladder function (time to first spontaneous urination, post-void residual urine volume, and time to complete micturition recovery), urodynamic function (free flow rate [FFR], filling-phase bladder pressure, and pressure-flow study during voiding), inflammatory factors (serum interleukin [IL]-6, tumor necrosis factor [TNF]-α, high-sensitivity-C reactive protein [hs-CRP]), and quality of life (QoL) assessed using the 36-Item Short-Form Health Survey [SF-36]).

RESULTS

The research group achieved an evidently higher overall response rate compared to the control group, with a lower incidence of postoperative complications, less intraoperative bleeding, reduced operation time, and more lymph nodes retrieved. Postoperative recovery was significantly improved in the research group, as evidenced by shorter time to intestinal function recovery, reduced bed rest duration, and shorter hospital stay. Bladder function recovery was also superior, with shorter time to first spontaneous urination and complete micturition recovery, as well as lower post-void residual urine volume. Regarding urodynamic outcomes, although FFR, filling phase bladder pressure, and pressure-flow indicators decreased postoperatively in both groups, these indicators remained significantly higher in the research group than in the control group. Moreover, postoperative levels of IL-6, TNF-α, and hs-CRP were markedly reduced in both group, with significantly lower levels in the research group. QoL assessment revealed significantly higher SF-36 scores in domains of role-emotional, social functioning, physical functioning, and general health in the research group compared to the control group.

CONCLUSION

Laparoscopic surgery outperforms open surgery for EEC treatment, significantly inhibiting serum inflammation and boosting patients' life quality.