A prospective study on nerve-sparing radical hysterectomy in patients with cervical cancer / 中华妇产科杂志

ABSTRACT

Objective To assess the nerve-sparing radical hysterectomy (NSRH) technique and its impact on postoperative voiding function. Methods Forty-fonr patients with International Federation of Gynecology and Obstetrics(FIGO) stage Ⅰ b1 - Ⅱ a cervical cancer were enrolled and randomized into NSRH group ( study group, n = 22) and conventional radical hysterectomy (CRH) group ( control group, n = 22). The pelvic autonomic nerve pathway (including hypogastric nerve, pelvic splanchnic nerve, inferior hypogastric plexus and bladder branch) was completely preserved in the NSRH group. Related parameters were compared between the two groups. Results The estimated blood loss in NSRH group and CRH group were (550±241) ml and (475±284) ml, respectively, with no significant difference (P >0. 05). The mean operation time in NSRH group and CRH group were (329±43) min and (272±56) min, respectively, with a significant difference (P < 0. 01). More patients in NSRH group had post-void residual urine volume (PVR) < 100 ml than that in CRH group on day 8 after surgery (68% vs. 18%, P <0. 01). The median duration of postoperative catheterization was significantly shorter in NRSH group (8 - 23 days, median 8 days) than that in CRH group ( 8 - 32 days, median 20 days; P < 0. 01 ). Neither surgery-related injury nor pathologically positive margin was reported in either of the groups. Conclusions NSRH is a feasible and safe technique for preserving bladder function. Larger prospective studies are needed to confirm the efficacy of this technique.