Vaginal-assisted laparoscopic radical hysterectomy: rationale, technique, results
| Autor: | Schneider A, Brink-Spalink, E. Gottschalk, Christardt Koehler, K. Hasenbein, Chiantera, Marnitz S, Malgorzata Lanowska |
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| Přispěvatelé: | Gottschalk, E., Lanowska, M., Chiantera, V., Marnitz, S., Schneider, A., Brink-Spalink, V., Hasenbein, K., Koehler, C. |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Uterine Cervical Neoplasm medicine.medical_specialty medicine.medical_treatment Uterine Cervical Neoplasms Urologic complication Postoperative Complications Urologic complications medicine Hysterectomy Vaginal Scientific Papers Humans Radical hysterectomy Endometrial Neoplasm Radical Hysterectomy Stage (cooking) Survival analysis Aged Neoplasm Staging Cervical cancer Aged 80 and over Hysterectomy business.industry Postoperative complication Middle Aged medicine.disease Settore MED/40 - Ginecologia E Ostetricia Survival Analysis Surgery Endometrial Neoplasms Laparoscopic radical hysterectomy medicine.anatomical_structure Treatment Outcome Vagina Female Laparoscopy Postoperative Complication Survival Analysi Neoplasm Grading business Human |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons |
| ISSN: | 1086-8089 |
| Popis: | The authors conclude that vaginal-assisted laparoscopic radical hysterectomy is an oncologic viable alternative to abdominal radical hysterectomy, laparoscopic-assisted radical vaginal hysterectomy, totally laparoscopic radical hysterectomy, and robotic radical hysterectomy. Objective: Total laparoscopic radical hysterectomy (TLRH) makes it difficult to resect adequate vaginal cuff according to tumor size and to avoid tumor spread after opening the vagina. Laparoscopic-assisted radical vaginal hysterectomy (LARVH) is associated with higher risk for urologic complications. Methods: The vaginal-assisted laparoscopic radical hysterectomy (VALRH) technique comprises 3 steps: (1) comprehensive laparoscopic staging, (2) creation of a tumor-adapted vaginal cuff, and (3) laparoscopic transsection of parametria. We retrospectively analyzed data of 122 patients who underwent VALRH for early stage cervical cancer (n=110) or stage II endometrial cancer (n=12) between January 2007 and December 2009 at Charité University Berlin. Results: All patients underwent VALRH without conversion. Mean operating time was 300 minutes, and mean blood loss was 123cc. On average, 36 lymph nodes were harvested. Intra- and postoperative complication rates were 0% and 13.1%, respectively. Resection was in sound margins in all patients. After median follow-up of 19 months, disease-free survival and overall survival for all 110 cervical cancer patients was 94% and 98%, and for the subgroup of patients (n=90) with tumors ≤pT1b1 N0 V0 L0/1 R0, 97% and 98%, respectively. Conclusion: VALRH is a valid alternative to abdominal radical hysterectomy and LARVH in patients with early-stage cervical cancer and endometrial cancer stage II with minimal intraoperative complications and identical oncologic outcomes. |
| Databáze: | OpenAIRE |
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