Total laparoscopic Wertheim’s radical hysterectomy versus Wertheim’s radical abdominal hysterectomy in the management of stage I cervical cancer in Singapore: a pilot study

Lim, Yong Kuei; Chia, Yin Nin; Yam, Kwai Lam

doi:10.11622/smedj.2013242

Cited by 12 publications

(24 citation statements)

References 20 publications

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“…The number of dissected lymph nodes reported in eight studies (Table 3 ) [ 20 – 23 , 25 , 27 , 28 , 30 , 31 ] showed comparable difference in both techniques (weighted mean difference = −1.06; 95 % CI −4.03 to 1.91; p = 0.48; Fig. 3 ).…”

Section: Resultsmentioning

confidence: 98%

Laparoscopy versus laparotomy for the management of early stage cervical cancer

et al. 2015

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BackgroundThe possible advantages of laparoscopic radical hysterectomy (LRH) versus open radical hysterectomy (RH) have not been well reviewed systematically. The aim of this study was to systematically review the comparative effectiveness between LRH and RH in the treatment of cervical cancer based on the evaluation of the Perioperative outcomes, oncological clearance, complications and long-term outcomes.MethodsThe systematic review was conducted by searching PubMed, MEDLINE, EMBASE, the Cochrane Library and BIOSIS databases. All original studies that compared LRH with RH were included for critical appraisal. Data were pooled and analyzed.ResultsA total of twelve original studies that compared LRH (n = 754) with RH (n = 785) in patients with cervical cancer fulfilled quality criteria were selected for review and meta-analysis. LRH compared with RH was associated with a significant reduction of intraoperative blood loss (weighted mean difference = −268.4 mL (95 % CI −361.6, −175.1; p < 0.01), a reduced risk of postoperative complications (OR = 0.46; 95 % CI 0.34–0.63) and shorter hospital stay (weighted mean difference = −3.22 days; 95 % CI–4.21, −2.23 days; p < 0.01). These benefits were at the cost of longer operative time (weighted mean difference = 26.9 min (95 % CI 8.08–45.82). The rate of intraoperative complications was similar in the two groups. Lymph nodes yield and positive resection margins were similar between the two groups. There were no significant differences in 5-year overall survival (HR 0.91, 95 % CI 0.48–1.71; p = 0.76) and 5-year disease-free survival (hazard ratio [HR] 0.97, 95 % CI 0.56–1.68; p = 0.91).ConclusionsLRH shows better short term outcomes compared with RH in patients with cervical cancer. The oncologic outcome and 5-year survival were similar between the two groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1818-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 98%

Laparoscopy versus laparotomy for the management of early stage cervical cancer

et al. 2015

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“…Table 1 shows the characteristics of included studies, which included 1 small RCT 15 (Level of Evidence 2b), 15 retrospective studies, 16–29 , 37 and 6 prospective studies 30–33 , 35 , 36 comparing a contemporary series of patients (Level of Evidence 3b). Five studies examined cases with Stage IB1 or below disease.…”

Section: Resultsmentioning

confidence: 99%

Prognostic and Safety Roles in Laparoscopic Versus Abdominal Radical Hysterectomy in Cervical Cancer: A Meta-analysis

Cao

Feng

Huang

et al. 2015

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Objective: Studies comparing the prognostic results between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) in cervical cancer reported contradictory results. We aimed to evaluate the prognostic and safety roles of LRH by pooling studies in a meta-analysis.Materials and Methods: Original articles were searched in PubMed, EMBASE, and the Cochrane Library. The survival results (5-year disease-free survival [DFS], 5-year overall survival [OS], and recurrence rate [RR]), safety parameters (intra-, peri-, and postoperative complication rates and postoperative bowel or bladder recovery days), efficiency parameters (pelvic/para-aortic lymph nodes removed), and other parameters (operative time, estimated blood loss, and hospital of stay) between the two approaches were reviewed.Results: For the 2922 cases identified, DFS, OS, and RR did not differ in balanced prognostic factors, including lymph node metastasis, Stage IIB or above, non–squamous cancer histology, grade G3, lymphovascular space invasion, tumor size ≥4 cm, and positive parametrial and vaginal margin rates. Meanwhile, LRH was associated with higher complication rates and a shorter time to the recovery of bowel or bladder function than for ARH. The number of removed pelvic or para-aortic lymph nodes did not significantly differ. Other parameters showed LRH was associated with a longer operative time, less blood loss, and a shorter length of hospital stay. The survival and prognostic results did not differ in balanced prognostic factors.Conclusions: LRH is safe and has lower operative complication rates than ARH.

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“…Egy 2015-ös metaanalízis, ami 12 klinikai vizsgálat eredményeit összegezi, a TRLH-t megfelelő technikának tartja a cervixcarcinoma műtéti ellátására, jobb rövid távú kimenetellel, mint az ARH [16] [17][18][19][20][21]. Malzoni és mtsai szerint a laparoszkópos csoportban szignifikánsan alacsonyabb intraoperatív vérveszteség és hospitalizáció, valamint hosszabb műtéti idő volt az ARH-csoporthoz képest.…”

Section: Megbeszélésunclassified

“…Sem a progreszsziómentes túlélésben, sem a teljes túlélésben nem volt különbség a két csoport között az ötéves nyomon követés során [19]. Lim és mtsai közleményében is kevesebbnek adódott az intraoperatív vérveszteség TLRH során, mint ARH kapcsán, de nem volt eltérés a műtéti időben, a vérvesztésben, a hospitalizációban, az eltávolított nyirokcsomók számában, valamint az intra-és posztoperatív komplikációk gyakoriságában [20]. Xiao és mtsai eredményeiben a TLRH-csoportban kevesebb volt a vérveszteség és a posztoperatív komplikáció, továbbá az ARHcsoportban több nyirokcsomót távolítottak el.…”

Section: Megbeszélésunclassified