A comparison of laparoscopically-assisted radical vaginal hysterectomy and radical abdominal hysterectomy in the treatment of cervical cancer / 부인종양

ABSTRACT

OBJECTIVE: The aim of this study was to compare peri-operative morbidity and safety of patients treated by laparoscopically-assisted radical vaginal hysterectomy (LARVH)with laparoscopic pelvic lymphadenectomy (LPL)and radical abdominal hysterectomy (RAH)with pelvic lymph node dissection (PLND) in early stage of cervical cancer. METHODS: Since September 2004,all patients with FIGO stage Ia-IIa cervical cancer undergoing radical surgery by members of our division have been entered into a prospective database. Two surgeons at our center have performed LARVH by Schneider method on all surgically appropriate patients. RESULTS: Between September 2004 and May 2005, 26 patients were performed LARVH with LPL,30 patients were performed RAH with PLND. There were no differences in estimated blood loss, the number of lymph nodes, duration of hospital stay and postoperative complications.But operative time was significantly prolonged in LARVH group. Intraoperative complications in the LARVH with LPL group included bladder injuries(2), shift to laparotomy due to ureter injury(1). There was one case of vesicovaginal fistula in the RAH group. CONCLUSION: LARVH with LPL in early stage of cervical cancer is a safe and technically effective alternative to RAH. Despite the inherent limitations of LARVH with LPL and its associated learning curve, the procedure conveys many advantages over the open laparotomy technics in terms of postoperative wound pain and recovery. However further study is needed to evaluate long-term recurrence rate and survival rate.