Is laparoscopically assisted radical vaginal hysterectomy for cervical carcinoma safe? A case control study with follow up

Abstract

Objective To compare a new surgical approach, laparoscopically assisted radical vaginal hysterectomy (LARVH) with open radical hysterectomy in women with cervical cancer. Can selected women benefit from the minimally invasive approach without compromising safety (recurrence rate) and morbidity (complications)?Design Retrospective case control study.Setting A tertiary referral unit for gynaecological malignancies.Population Thirty women undergoing LARVH were included and compared with 30 women undergoing open radical surgery. The control group was matched for age, body mass index and disease stage.Methods Retrospective collection of data from patient files and follow up.Main outcome measures Recurrence rate, complication rate, hospital stay, nodal counts, blood loss, operating time.Results Recurrence rates were equal (6.7%). There was one death, in the LARVH group. Conclusions The first 30 LARVH procedures performed in this unit are comparable in terms of safety (recurrence rate and complication rate) and economic factors (shorter hospital stay mitigating longer operating time). Further development of this technique is warranted.

Early experience of laparoscopically assisted radical vaginal hysterectomy (Coelio-Schauta) versus abdominal radical hysterectomy for early stage cervical cancer

“…In this study, both LARVH and RH appeared equally efficacious in the treatment of early-stage cervical cancer with no recurrences in either group, in contrast to other published data [17,18]. The two procedures carry similar complication rates but with a different pattern of problems following each.…”

Total laparoscopic radical hysterectomy for treatment of uterine malignant tumors: Analysis of short-term therapeutic efficacy

“…Studies on the efficacy of the TLRH plus pelvic lymph node dissection for the treatment of the early cervical cancer indicated TLRH has the advantage of small trauma and less bleeding, faster postoperative recovery over the tradition abdominal radical hysterectomy (ARH) [6][7][8][9] . A retrospective analysis of 60 patients with early cervical cancer conducted by Zakashansky et al [10] showed that in this cohort, no conversion to laparotomy appeared; the intraoperative blood loss was only 200 mL, far less than 520 mL in ARH; there was no intraoperative blood transfusion compared to 5 cases (5/30) of intraoperative blood transfusion in laparotomy; the average hospital stay in TRLH was 1.8 days, shorter than that in ARH; however, the operative time lasted 318.5 min in TRLH, significantly longer than 242.5 min in ARH.…”

“…In recent years, studies have shown that the TLRH plus pelvic lymph node dissection possesses more advantages than traditional laparotomy, such as small trauma, less bleeding, quick recovery [5][6] . However, as the laparoscopic surgery is technically challenging and may cause many complications, the feasibility and safety of the laparoscopic approach are warranted for more investigations [7][8] . This study retrospectively analyzed the data of 110 patients with cervical cancer or endometrial cancer who underwent TLRH plus pelvic lymph node dissection in a period of 15 months with an attempt to examine the short-term efficacy and application value of the surgical procedure for the treatment of uterine malignant tumors.…”

Comparative evaluation of surgical stress of laparoscopically assisted vaginal radical hysterectomy and lymphadenectomy and laparotomy for early-stage cervical cancer

“…Research has shown that laparoscopic radical hysterectomy is feasible and safe and induces less trauma due to less intraoperative bleeding, less postoperative pain, a shorter period of recovery and a shorter hospital stay, while the number of lymph nodes removed was almost equal to that shown in conventional open surgery (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Laparoscopically assisted vaginal hysterectomy has become the preferred approach for cervical cancer treatment.…”