Laparoscopically Assisted Vaginal Radical Hysterectomy: Systematic Review of the Literature
| Autor: | Georgios D. Vlachos, V Pergialiotis, Nikolaos Thomakos, Aristides Antsaklis, Dimitrios Christakis, Alexandros Rodolakis |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Cervical cancer medicine.medical_specialty business.industry medicine.medical_treatment MEDLINE Obstetrics and Gynecology Retrospective cohort study medicine.disease Cervical conization law.invention Surgery Treatment Outcome Randomized controlled trial law Hysterectomy Vaginal medicine Adjuvant therapy Humans Female Laparoscopy Radical Hysterectomy Prospective cohort study business Retrospective Studies |
| Zdroj: | Journal of Minimally Invasive Gynecology. 20:745-753 |
| ISSN: | 1553-4650 |
| DOI: | 10.1016/j.jmig.2013.04.021 |
| Popis: | Laparoscopically assisted vaginal radical vaginal hysterectomy (LAVRH), a minimally invasive technique that seems to be an attractive alternative to traditional surgery, remains unexplored in the treatment of cervical cancer. We searched Medline (1966-2013) and Scopus (2004-2013) search engines, as well as reference lists from all included studies. Ten studies were retrieved; including 6 retrospective cohort studies, 2 prospective cohort studies, 1 retrospective randomized trial, and a phase II randomized control trial. LAVRH provided equal recurrence-free rates when performed in patients with tumors not exceeding 2 cm in greatest diameter. Its main advantages seem to be less intraoperative blood loss and more radical pelvic lymphadenectomy. The primary disadvantages of the technique are a higher rate of disease-positive surgical margins, resulting in the need for adjuvant therapy, and the slow learning curve required for a surgeon to gain expertise. With use in minimally invasive surgery of newer techniques such as total laparoscopic radical hysterectomy and robotic-assisted radical hysterectomy, and possible future adoption of more conservative techniques such as cervical conization with pelvic lymphadenectomy, the question remains as to whether LAVRH will be adopted by the surgical community or lost to oblivion. |
| Databáze: | OpenAIRE |
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