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Laparoscopic radical trachelectomy: technique, feasibility, and outcomes.

Saadi JM, Perrotta M, Orti R, Salvo G, Giavedoni ME, Gogorza S, Testa R - JSLS (2015 Jan-Mar)

Bottom Line: During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously.No patient required conversion to laparotomy.Minimally invasive surgery provides the widely known benefits of this type of approach.

View Article: PubMed Central - PubMed

Affiliation: Gynecologic Oncology Unit, Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

ABSTRACT

Background and objectives: Our objectives are to describe our surgical technique for laparoscopic radical trachelectomy, to evaluate its feasibility, and to present the perioperative results at Hospital Italiano de Buenos Aires, Argentina.

Methods: We analyzed 4 patients who underwent laparoscopic radical trachelectomy for early-stage cervical cancer between December 2011 and May 2013.

Results: Four patients were included in this study. Total laparoscopic radical trachelectomy was performed in all cases. The mean age was 26 years (range, 19-32 years), the mean body mass index was 21 (range, 18-23), and the mean length of hospital stay was 33 hours (range, 24-36 hours). The mean operative time was 225 minutes (range, 210-240 minutes), and no complications were reported. During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously. The pelvic and parametrial lymph nodes, as well as the vaginal cuff and cervical resection margins, were negative for malignancy in all cases. On average, 18 pelvic lymph nodes (range, 15-20) were removed. The tumor stage was IB in all 4 patients, and the mean tumor size was 17 mm (range, 12-31 mm). No patient required conversion to laparotomy.

Conclusion: We consider laparoscopic radical trachelectomy, performed by trained surgeons, a feasible and safe therapeutic option as a fertility-sparing surgical technique, with good perioperative outcomes for women with early-stage cervical cancer with a desire to preserve their fertility. Minimally invasive surgery provides the widely known benefits of this type of approach.

No MeSH data available.


Related in: MedlinePlus

Trocar placement.
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Figure 1: Trocar placement.

Mentions: Four laparoscopic trocars were placed. The primary, 12-mm trocar was placed in the umbilical region, whereas the other 3 accessory trocars were placed as follows: 10 mm in the right iliac fossa, 5 mm in the left iliac fossa, and 5 mm in the suprapubic region (Figure 1).


Laparoscopic radical trachelectomy: technique, feasibility, and outcomes.

Saadi JM, Perrotta M, Orti R, Salvo G, Giavedoni ME, Gogorza S, Testa R - JSLS (2015 Jan-Mar)

Trocar placement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4376216&req=5

Figure 1: Trocar placement.
Mentions: Four laparoscopic trocars were placed. The primary, 12-mm trocar was placed in the umbilical region, whereas the other 3 accessory trocars were placed as follows: 10 mm in the right iliac fossa, 5 mm in the left iliac fossa, and 5 mm in the suprapubic region (Figure 1).

Bottom Line: During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously.No patient required conversion to laparotomy.Minimally invasive surgery provides the widely known benefits of this type of approach.

View Article: PubMed Central - PubMed

Affiliation: Gynecologic Oncology Unit, Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

ABSTRACT

Background and objectives: Our objectives are to describe our surgical technique for laparoscopic radical trachelectomy, to evaluate its feasibility, and to present the perioperative results at Hospital Italiano de Buenos Aires, Argentina.

Methods: We analyzed 4 patients who underwent laparoscopic radical trachelectomy for early-stage cervical cancer between December 2011 and May 2013.

Results: Four patients were included in this study. Total laparoscopic radical trachelectomy was performed in all cases. The mean age was 26 years (range, 19-32 years), the mean body mass index was 21 (range, 18-23), and the mean length of hospital stay was 33 hours (range, 24-36 hours). The mean operative time was 225 minutes (range, 210-240 minutes), and no complications were reported. During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously. The pelvic and parametrial lymph nodes, as well as the vaginal cuff and cervical resection margins, were negative for malignancy in all cases. On average, 18 pelvic lymph nodes (range, 15-20) were removed. The tumor stage was IB in all 4 patients, and the mean tumor size was 17 mm (range, 12-31 mm). No patient required conversion to laparotomy.

Conclusion: We consider laparoscopic radical trachelectomy, performed by trained surgeons, a feasible and safe therapeutic option as a fertility-sparing surgical technique, with good perioperative outcomes for women with early-stage cervical cancer with a desire to preserve their fertility. Minimally invasive surgery provides the widely known benefits of this type of approach.

No MeSH data available.


Related in: MedlinePlus