Total Laparoscopic Radical Hysterectomy Versus Abdominal Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: Our Experience

Malzoni, Mario; Tinelli, Andrea; Cosentino, Francesco; Fusco, Alfredo; Malzoni, Carmine

doi:10.1245/s10434-009-0342-7

Cited by 151 publications

(94 citation statements)

References 22 publications

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“…Complications of TVSE are reportedly infrequent [9,10], but the risk of infection due to the transvaginal maneuvers is of concern. In our department, we irrigate the vagina and abdominal cavity with saline before and after extraction, and an Alexis® wound retractor and tissue collection bags are used for specimen extraction so as to protect the vagina and help prevent infections.…”

Section: Discussionmentioning

confidence: 99%

“…No relapse specifically caused by TVSE has been reported for colon cancer [9,12]; however, some reports have pointed out that to prevent peritoneal dissemination or delivery site metastasis, specimens should be put in a bag before extraction [6]. However, others claim that as long as oncological principles and procedures are followed, there should be no increase in the dissemination as a result of TVSE, and the validity of TVSE in early-stage uterine cervical cancer has been demonstrated in the field of gynecology [10]. In this case, the specimen was put in a collection bag for extraction.…”

Section: Discussionmentioning

confidence: 99%

“…"Natural orifice specimen extraction" (NOSE) techniques that are similar to NOTES have been attempted in recent years. Transvaginal specimen extraction (TVSE), one of these techniques, has been attempted mainly in Europe and the USA, and it is claimed to have the advantages of reducing surgical wound pain, reducing wound complications, shortening the period of hospitalization, and ensuring excellent esthetic outcomes [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Widespread experience with laparoscopic pancreatectomies has allowed safe splenectomies in the supine position, by a safe and even less invasive surgical method using TVSE without the changing of body positions as required in conventional laparoscopic splenectomy [5][6][7][8][9][10]. The present surgical procedure was performed after obtaining approval from the Japanese Meabashi Red Cross hospital ethical committee.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Splenic Metastasis of Ovarian Cancer Treated with Complete Laparoscopic Splenectomy and Transvaginal Specimen Extraction

et al. 2016

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A 61-year-old woman was diagnosed with right inguinal lymph node and splenic metastasis of ovarian serous cystadenocarcinoma. We performed right inguinal lymph node dissection and total laparoscopic splenectomy in the supine position followed by transvaginal specimen extraction (TVSE). First, using three ports, we extracted the right inguinal lymph node. We repaired the posterior wall of the inguinal canal using a mesh plug. We added two ports and displaced the spleen from the retroperitoneum and lifted it using a snake retractor, disconnecting the hilum using an automatic suturing device. Next, the posterior wall of the vagina was intraperitoneally incised. And an Alexis® laparoscopic system was inserted into the vagina. The cap maintained aeroperitoneum, a collection bag was inserted in the abdominal cavity via the vagina, and the spleen was collected. When the spleen was removed from the body, partial fragmentation of the organ was required in the bag. Organ fragmentation was performed only within the bag, and we made sure not to tear the bag. The vaginal wound was laparoscopically sutured. The patient had no operative complications and was able to actively ambulate at the first day after surgery due to a slight postoperative pain. Total laparoscopic splenectomy with TVSE in the supine position may be a safe and feasible method for selected female patients. This technique enables minimally invasive surgery for female patients with splenic disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Splenic Metastasis of Ovarian Cancer Treated with Complete Laparoscopic Splenectomy and Transvaginal Specimen Extraction

et al. 2016

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“…Over a thousand laparoscopic radical hysterectomies have been performed to-date, 21,22,23,24 . However, laparoscopic surgery has not gained popularity amongst gynaecological oncologists.…”

Section: Laparoscopic Radical Hysterectomy With Pelvic Lymphadenectomymentioning

confidence: 99%

New Approaches to Hysterectomy by Minimal Invasive Surgery (MIS)

Raju-Kankipati¹,

Devaja²

2012

Hysterectomy

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Survival After Minimally Invasive vs Open Radical Hysterectomy for Early-Stage Cervical Cancer

et al. 2020

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IMPORTANCE Minimally invasive techniques are increasingly common in cancer surgery. A recent randomized clinical trial has brought into question the safety of minimally invasive radical hysterectomy for cervical cancer.OBJECTIVE To quantify the risk of recurrence and death associated with minimally invasive vs open radical hysterectomy for early-stage cervical cancer reported in observational studies optimized to control for confounding. Ovid MEDLINE, Ovid Embase, PubMed, Scopus, and Web of Science (inception to March 26, 2020) performed in an academic medical setting. DATA SOURCESSTUDY SELECTION In this systematic review and meta-analysis, observational studies were abstracted that used survival analyses to compare outcomes after minimally invasive (laparoscopic or robot-assisted) and open radical hysterectomy in patients with early-stage (International Federation of Gynecology and Obstetrics 2009 stage IA1-IIA) cervical cancer. Study quality was assessed with the Newcastle-Ottawa Scale and included studies with scores of at least 7 points that controlled for confounding by tumor size or stage. DATA EXTRACTION AND SYNTHESISThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist was used to abstract data independently by multiple observers. Random-effects models were used to pool associations and to analyze the association between surgical approach and oncologic outcomes.MAIN OUTCOMES AND MEASURES Risk of recurrence or death and risk of all-cause mortality.RESULTS Forty-nine studies were identified, of which 15 were included in the meta-analysis. Of 9499 patients who underwent radical hysterectomy, 49% (n = 4684) received minimally invasive surgery; of these, 57% (n = 2675) received robot-assisted laparoscopy. There were 530 recurrences and 451 deaths reported. The pooled hazard of recurrence or death was 71% higher among patients who underwent minimally invasive radical hysterectomy compared with those who underwent open surgery (hazard ratio [HR], 1.71; 95% CI, 1.36-2.15; P < .001), and the hazard of death was 56% higher (HR, 1.56; 95% CI, 1.16-2.11; P = .004). Heterogeneity of associations was low to moderate. No association was found between the prevalence of robot-assisted surgery and the magnitude of association between minimally invasive radical hysterectomy and hazard of recurrence or death (2.0% increase in the HR for each 10-percentage point increase in prevalence of robot-assisted surgery [95% CI, −3.4% to 7.7%]) or all-cause mortality (3.7% increase in the HR for each 10-percentage point increase in prevalence of robot-assisted surgery [95% CI, −4.5% to 12.6%]).CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis of observational studies found that among patients undergoing radical hysterectomy for early-stage cervical cancer, minimally invasive radical hysterectomy was associated with an elevated risk of recurrence and death compared with open surgery.

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Total Laparoscopic Radical Hysterectomy Versus Abdominal Radical Hysterectomy with Lymphadenectomy in Patients with Early Cervical Cancer: Our Experience

Cited by 151 publications

References 22 publications

A Case of Splenic Metastasis of Ovarian Cancer Treated with Complete Laparoscopic Splenectomy and Transvaginal Specimen Extraction

A Case of Splenic Metastasis of Ovarian Cancer Treated with Complete Laparoscopic Splenectomy and Transvaginal Specimen Extraction

New Approaches to Hysterectomy by Minimal Invasive Surgery (MIS)

Survival After Minimally Invasive vs Open Radical Hysterectomy for Early-Stage Cervical Cancer

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