The incidence of urologic complications requiring urologic procedure in radical hysterectomy and difference between abdominal radical hysterectomy and laparoscopic radical hysterectomy

Kim, Hyeong-Su; Jeong, Hojin; Kim, Bo Wook; Hwang, Jong Ha

doi:10.3802/jgo.2021.32.e84

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…A recent study evaluated the incidence of urologic complications requiring urological procedure in radical hysterectomy and the differences in incidence after open and laparoscopic approaches. [ 17 ] The general incidence was 7.4%, with the most common urological procedure being the insertion of double-J catheter 5.18% followed by bladder repair 0.9%,[ 17 ] with no significant difference in urological complications after open or laparoscopic radical hysterectomy, but with significantly higher incidence of bladder repair after the laparoscopic approach. In the present study, the urological complication requiring urological procedures was 7.07% with 3.03% requiring a double-J catheter, 2.02% urethrovesical catheterization (Foley probe), 1.51% surgical management, and 0.5% nephrostomy.…”

Section: Discussionmentioning

confidence: 99%

Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience

Minciuna,

Ivanov,

Aioanei

et al. 2023

Gynecology and Minimally Invasive Therapy

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Objectives: Minimally invasive surgery (MIS) has become the preferred option for many gynecologic pathologies since complication rate and postoperative recovery time have decreased considerably. Postoperative complications remain an important aspect when using the MIS approach, if they are not timely or accurately diagnosed and treated. The main aim of the study is to first assess their incidence, followed by identifying possible risk factors. Furthermore, the secondary aim is to identify if the type of MIS approach used, robotic or laparoscopic, may render some additional benefits. Materials and Methods: The database of the General Surgery Department was queried between 2008 and 2019 for patients with gynecologic pathology: 2907 cases were identified. An additional selection was performed using the following filters: MIS and neoplasia. All emergency surgeries were excluded. One hundred and ninety-eight cases were obtained. Results: The majority of complications were urological (11.6%) with only 7.07% requiring a specific urological procedure. The second most common was lymphorrhea 4.5%. Dindo–Clavien classification correlates positively with the postoperative hospital stay (PHS) (P = 0.000), the type of surgery (P = 0.046), the primary tumor location (P = 0.011), conversion rate (P = 0.049), the expertise of the lead surgeon (P = 0.012), and the operative time (P = 0.002). The urological complications correlate positively with the type of surgery (P = 0.002), the tumor location (P = 0.001), early reintervention (P = 0.000), operative time (P = 0.006), postoperative hemorrhage (P = 0.000), pelvic abscess (P = 0.000), venous thrombosis (P = 0.011), and postoperative cardiac complications (P = 0.002). Laparoscopic and robotic approaches were comparatively assessed. The PHS (P = 0.025), the type of surgery performed (P = 0.000), and primary tumor location (P = 0.011) were statistically significantly different. Conclusion: Postoperative complications reported after MIS for gynecological malignancies show similar incidence as in the current literature, also taking into consideration those for the open approach. The robotic approach seems to be able to perform more complex surgeries with no difference in the postoperative complication rates. The expertise of the lead surgeon in gynecology correlates with lower postoperative complications. Further prospective studies are needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience

Minciuna,

Ivanov,

Aioanei

et al. 2023

Gynecology and Minimally Invasive Therapy

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“…However, when considering urologic complications, clear differences between the open and minimally invasive approaches have not been identified [62]. The LACC trial brought about a radical change in cervical cancer surgery by leading to a dramatic shift to the surgical open technique [35].…”

Section: Discussionmentioning

confidence: 99%

“…-Many of the studies we found were retrospective, which could reduce the level of evidence; -We excluded all non-English studies, potentially introducing a bias to our findings; -Stratification based on the cervical cancer stage was not possible, since few studies provided this information, even if cervical cancer stage is one of the most relevant risk factors for surgical urologic complications [35]; -…”

Section: Discussionmentioning

confidence: 99%

Urological Complications in Radical Surgery for Cervical Cancer: A Comparative Meta-Analysis before and after LACC Trial

Bruno,

Chiofalo,

Logoteta

et al. 2023

JCM

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Background: After the LACC trial publication in 2018, the minimally invasive approach (MIS) has severely decreased in favor of open surgery: MIS radical hysterectomy was associated with worse oncological outcomes than open surgery, but urological complications were never extensively explored in pre- versus post-LACC eras, even if they had a great impact on post-operative QoL. The purpose of this meta-analysis is to compare functional and organic urological complication rates before and after LACC trial. Methods: An independent search of the literature was conducted 4 years before and after the LACC trial and 50 studies were included. Results: The overall rate of urologic complications was higher in pre-LACC studies while no differences were found for organic urological complications. Conversely, the overall risk of dysfunctional urological complications showed a higher rate in the pre-LACC era. This is probably related to a sudden shift to open surgery, with potential lower thermal damage to the urinary tract autonomic nervous fibers. Conclusions: This meta-analysis showed that the incidence of urological complications in radical cervical cancer surgery was higher before the LACC trial, potentially due to the shift to open surgery. Nevertheless, further studies are needed to shed light on the connection between minimally invasive surgery and urological damage.

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“…On the other hand, in comparison to total hysterectomy, radical hysterectomy has a higher risk of surgery related complications, such as urinary, nerve and vascular injury(Obermair et al 2020 ; Kim et al 2021 ; Plante et al 2023 ). The incidence of postoperative urinary incontinence and urinary retention is 11.0% and 9.9%, respectively, in patients receiving radical hysterectomy, compared to 4.7% and 0.6%, respectively, in patients undergoing total hysterectomy(Plante et al 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Total hysterectomy versus radical hysterectomy in neuroendocrine cervical cancer: a SEER-database analysis

Zeng,

Guo,

Xia

et al. 2024

J Cancer Res Clin Oncol

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Purpose We conducted this study to evaluate the efficacy of total hysterectomy versus radical hysterectomy in the treatment of neuroendocrine cervical cancer (NECC). Methods Eligible NECC patients were identified from the Surveillance, Epidemiology and End Results (SEER) database. Demographic characteristics, clinical treatment and survival of the patients were collected. The overall survival (OS) and cancer-specific survival (CSS) were estimated by Kaplan–Meier analysis with log-rank test. Results A total of 286 patients were included, with 104 patients undergoing total hysterectomy and 182 patients undergoing radical hysterectomy. The 5-year OS were 50.8% in the total hysterectomy group and 47.5% in the radical hysterectomy group (p = 0.450); and the corresponding 5-year CSS were 51.6% and 49.1% (p = 0.494), respectively. Along with surgery, radiotherapy was given to 49.0% of patients in the total hysterectomy group and 50.5% in the radical hysterectomy group; and chemotherapy was administered to 77.9% of patients in the total hysterectomy group and 85.7% in the radical hysterectomy group. Unexpectedly, in patients who received adjuvant radiotherapy with or without chemotherapy, the OS was superior in the total hysterectomy group compared with the radical hysterectomy group (p = 0.034). While in patients who received chemotherapy alone and those who received neither radiotherapy nor chemotherapy, the OS still remained comparable between the total hysterectomy and radical hysterectomy group. Conclusion Compared with radical hysterectomy, total hysterectomy was not associated with compromised survival prognosis in patients with NECC. Total hysterectomy has the potential to be a surgical alternative in the multimodal management of NECC.

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The incidence of urologic complications requiring urologic procedure in radical hysterectomy and difference between abdominal radical hysterectomy and laparoscopic radical hysterectomy

Cited by 3 publications

References 22 publications

Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience

Short-term Outcome of Robotic and Laparoscopic Surgery for Gynecological Malignancies: A Single-center Experience

Urological Complications in Radical Surgery for Cervical Cancer: A Comparative Meta-Analysis before and after LACC Trial

Total hysterectomy versus radical hysterectomy in neuroendocrine cervical cancer: a SEER-database analysis

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