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Total Laparoscopic Versus Laparotomic Radical Hysterectomy and Lymphadenectomy in Cervical Cancer: An Observational Study of 13-Year Experience.

Xiao M, Zhang Z - Medicine (Baltimore) (2015)

Bottom Line: In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group.Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001).Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
This article aims to review our 13-year experience in the treatment of patients with cervical cancer by comparing total laparoscopic radical hysterectomy and lymphadenectomy with laparotomy.We reviewed all patients undergoing total laparoscopic or laparotomic radical hysterectomy and lymphadenectomy because of cervical cancer between 2001 and 2014 in our hospital.In total, 154 eligible patients with International Federation of Gynecology and Obstetrics Ia-IIb were enrolled, including 106 patients undergoing total laparoscopic procedure and 48 patients undergoing laparotomic procedure. In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group. Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001). Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy. Disease-free survival rates were 89.7% and 88.9% in total laparoscopy and laparotomy groups (P = 0.39), respectively, and overall survival rates were 90.2% in total laparoscopy group and 91.3% in laparotomy group (P = 0.40).Total laparoscopic procedure is a surgically and oncologically safe and reliable alternative to laparotomic procedure in the treatment for cervical cancer.

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Comparison of dissected lymph nodes for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH).
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Figure 1: Comparison of dissected lymph nodes for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH).

Mentions: Patients’ information and tumor characteristics are specified in Table 1. Mean ages were 43.7 (range, 22–68) years and 45.7 (range, 28–78) years in total laparoscopy group and laparotomy group, respectively. Patients had a mean body mass index (BMI) of 23.8 (range, 17.5–42.5) kg/m2 and 24.7 (range, 17.2–36.0) kg/m2 in total laparoscopy and laparotomy groups, respectively. No significant differences were found in age, BMI, and tumor characteristics, such as FIGO stage. More lymph nodes were dissected in laparotomy group than that in the total laparoscopy group (mean, 24.3 vs 20.5, P = 0.008), whereas no significant differences were observed regarding number of metastatic lymph nodes and the dissected lymph nodes for patients with metastatic lymph nodes between the 2 groups, showed in Figure 1.


Total Laparoscopic Versus Laparotomic Radical Hysterectomy and Lymphadenectomy in Cervical Cancer: An Observational Study of 13-Year Experience.

Xiao M, Zhang Z - Medicine (Baltimore) (2015)

Comparison of dissected lymph nodes for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554128&req=5

Figure 1: Comparison of dissected lymph nodes for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH).
Mentions: Patients’ information and tumor characteristics are specified in Table 1. Mean ages were 43.7 (range, 22–68) years and 45.7 (range, 28–78) years in total laparoscopy group and laparotomy group, respectively. Patients had a mean body mass index (BMI) of 23.8 (range, 17.5–42.5) kg/m2 and 24.7 (range, 17.2–36.0) kg/m2 in total laparoscopy and laparotomy groups, respectively. No significant differences were found in age, BMI, and tumor characteristics, such as FIGO stage. More lymph nodes were dissected in laparotomy group than that in the total laparoscopy group (mean, 24.3 vs 20.5, P = 0.008), whereas no significant differences were observed regarding number of metastatic lymph nodes and the dissected lymph nodes for patients with metastatic lymph nodes between the 2 groups, showed in Figure 1.

Bottom Line: In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group.Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001).Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
This article aims to review our 13-year experience in the treatment of patients with cervical cancer by comparing total laparoscopic radical hysterectomy and lymphadenectomy with laparotomy.We reviewed all patients undergoing total laparoscopic or laparotomic radical hysterectomy and lymphadenectomy because of cervical cancer between 2001 and 2014 in our hospital.In total, 154 eligible patients with International Federation of Gynecology and Obstetrics Ia-IIb were enrolled, including 106 patients undergoing total laparoscopic procedure and 48 patients undergoing laparotomic procedure. In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group. Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001). Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy. Disease-free survival rates were 89.7% and 88.9% in total laparoscopy and laparotomy groups (P = 0.39), respectively, and overall survival rates were 90.2% in total laparoscopy group and 91.3% in laparotomy group (P = 0.40).Total laparoscopic procedure is a surgically and oncologically safe and reliable alternative to laparotomic procedure in the treatment for cervical cancer.

Show MeSH
Related in: MedlinePlus