Surgicopathologic outcome of laparoscopic versus open radical hysterectomy

Ghezzi, Fabio; Cromi, Antonella; Ciravolo, Giuseppe; Volpi, Eugenio; Uccella, Stefano; Rampinelli, Fabio; Bergamini, Valentino

doi:10.1016/j.ygyno.2007.04.027

Cited by 82 publications

(60 citation statements)

References 23 publications

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“…(13) That small study confirmed the short-term surgical benefits of LARVH, but cautioned that LARVH is a less radical procedure than RAH and should be restricted to women with small tumours. (13) In the literature, median blood loss has been reported to range from 55 mL to 400 mL for TLRH, (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and from 800 mL to 1,500 mL for RAH. (17) The results of our study compared favourably with other series in the literature, with a significantly lower median blood loss for the TLRH group.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic radical hysterectomy with pelvic lymphadenectomy was first reported in the early 1990s, (1,2) and with increased experience in the technique, several large cancer centres have in the last decade reported its technical efficacy and safety. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) The main advantages of laparoscopic surgery include low amount of blood loss, short hospitalisation period, early recovery and reduced wound infection. Although no large randomised studies have been conducted to date, the results of recent cohort studies with long-term follow-up suggest that the oncologic outcome of laparoscopic surgery is comparable to surgery using the traditional laparotomy route.…”

Section: Introductionmentioning

confidence: 99%

“…Although no large randomised studies have been conducted to date, the results of recent cohort studies with long-term follow-up suggest that the oncologic outcome of laparoscopic surgery is comparable to surgery using the traditional laparotomy route. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) Thus, the aim of this article is to describe the early experience of total laparoscopic Wertheim's radical hysterectomy (TLRH) in the management of early cervical cancer in Singapore. This is the first and largest series reported in Singapore.…”

Section: Introductionmentioning

confidence: 99%

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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

Lim¹,

Chia²,

Yam³

2013

smedj

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METHODSThis was a prospective pilot study comparing TLRH with RAH in a single large tertiary institution in Singapore. Inclusion criteria included surgically fit patients with early cervical cancer and no radiological evidence of regional or distant metastases. RESUlTSFrom November 2009 to February 2011, a total of 18 TLRHs and 30 RAHs were performed. The median blood loss in the TLRH group was significantly lower than that in the RAH group (300 mL vs. 500 mL; p = 0.04). However, there was no statistically significant difference found between the two techniques in terms of operative time, hospital stay, bladder recovery, total lymph node yield or adjuvant treatment. No intraoperative bladder, ureteric or bowel complications were observed in the two groups. Postoperative complications occurred in 2 (11.1%) TLRH patients and 4 (13.3%) RAH patients. With a median follow-up of 37.3 (range 10-68) weeks, the rate of recurrence was found to be 5.6% for the TLRH group and 10.0% for the RAH group. CONClUSIONThe results of our study suggest that with appropriate patient selection and increased experience, TLRH can be a safe and effective procedure for the management of early cervical cancer in Singapore.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Lim¹,

Chia²,

Yam³

2013

smedj

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“…Radicality of laparoscopic surgery in patients with cervical cancer can be compared with the classical method. Therefore, surgical excision parts were analyzed in a study by Ghezii et al Results reported parameters resection was the same in class II radical hysterectomies performed laparoscopically or classic (2.4 cm vs. 2.3 cm), and in the case of class III hysterectomy no statistically significant differences (resection parameters 3.8 cm vs. 3.4 cm) [10]. For cases of cervical cancer in the early stages, IA2-IB1, Malzoni et al published the results of a study conducted on a group of patients who received laparoscopic radical hysterectomy class II or III with lymphadenectomy.…”

Section: Laparoscopic Surgery Versus Open Surgery In Uterine Cervicalmentioning

confidence: 99%

Minimally Invasive Surgery: A New Approach for Uterine Cervical Cancer

Gavrilescu¹,

Todosi²,

Ioanid³

et al. 2015

Surgery

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IntroductionIn the early 1990s, the laparoscopic approach in uterine cervical cancer has started to become quite popular among oncologist surgeons in order to minimize postoperative morbidity. When a new surgical technique is taken into consideration or suggested, it is compared with the standard therapy hitherto. Important issues to be taken into account include the feasibility and applicability of the new technique, intraoperative and postoperative complications and in oncological cases, survival and risk of recurrence.Gold standard for uterine cervical cancer in the early stages was abdominal radical hysterectomy with pelvic lymphadenectomy for more than 100 years. This technique, described for the first time Wertheim, Meigs subsequently underwent some changes. The first laparoscopic hysterectomy was performed and published in 1989 [1], but the first laparoscopic radical hysterectomy with pelvic and paraaortic lymphadenectomy in a patient with cervical cancer stage IA2 was performed by Nezha et al. in June 1989 and reported in 1992 [2]. Since then, it has been reported in the literature over 1000 cases [3]. Laparoscopic Surgery versus Open Surgery in Uterine Cervical CancerInitially used for diagnostic, laparoscopy has become a method of treatment in the field of gynecological surgery, but also in many other field. The results of laparoscopic surgery are now comparable with those obtained by laparotomy in benign and malignant pathologies. The most important advantages of the laparoscopic technique include more pleasing cosmetic appearance, or minimum parietal infectious complications, low incidence of adhesion formation, low cost associated with hospitalization and recovery period smaller resumption of daily activities in a shorter period [4]. In a study comparing the two surgical techniques, the results show an average of operating time with significant differences statistically 231.7 minutes for cases treated laparoscopically and 207 minutes to classical surgery, which can be explained by the fact that laparoscopic hysterectomies implemented quite recently requires a learning curve. The surgeons will become more familiar with laparoscopic procedure; the operative time is expected to become shorter. Intraoperative blood loss was lower in the laparoscopy (161.1 ml) compared with the traditional method (394.4 ml), with blood transfusions in 3 patients. Postoperative complications, represented mostly wound infections were recorded only in the group that received radical abdominal hysterectomy. The hospital stay was less in laparoscopic interventions (mean=2.9 days) compared with the second procedure (mean=5. A randomized, multicenter study including 116 patients demonstrated that laparoscopic assisted vaginal hysterectomy can be performed in a similar operating time classic surgery with intraoperative blood loss less and a relatively shorter period of hospitalization (p<0.01). Postoperative pain, another important parameter discussed, is lower for the first 3 days of laparoscopy versus open surgery (p<0.5) [7]....

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“…A few reports for laparoscopic radical hysterectomy and lymphadenectomy show that it is combined with larger operative time (even for experienced surgeons), less blood loss, fewer complications and a shorter hospital stay. [24,25] …”

Section: Laparoscopy In Cancermentioning

confidence: 99%