Total Laparoscopic Nerve-Sparing Radical Parametrectomy for Occult Early-Stage Cervical Cancer: Surgical Technique and Postoperative Bladder Function

2015 ◽  
Vol 80 (2) ◽  
pp. 128-133
Author(s):  
Hiroyuki Kanao ◽  
Kazuko Fujiwara ◽  
Keiko Ebisawa ◽  
Tomonori Hada ◽  
Yoshiaki Ota ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Surgical Technique ◽  
Early Stage ◽  
Bladder Function ◽  
Nerve Sparing ◽  
Early Stage Cervical Cancer ◽  
Radical Parametrectomy

Self-Reported Long-Term Autonomic Function After Laparoscopic Total Mesometrial Resection for Early-Stage Cervical Cancer: A Multicentric Study

2017 ◽  
Vol 27 (7) ◽  
pp. 1501-1507 ◽  
Author(s):  
Alessandro Lucidi ◽  
Swetlana Windemut ◽  
Marco Petrillo ◽  
Margherita Dessole ◽  
Giulio Sozzi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Vaginal Hysterectomy ◽  
Early Stage ◽  
Nerve Sparing ◽  
Laparoscopic Radical Hysterectomy ◽  
Early Stage Cervical Cancer ◽  
Laparoscopic Assisted

ObjectivesThis multicentric retrospective study investigates the early and long-term self-reported urinary, bowel, and sexual dysfunctions in early-stage cervical cancer patients who submitted to laparoscopic total mesometrial resection (L-TMMR), total laparoscopic radical hysterectomy, vaginal-assisted laparoscopic radical hysterectomy, and laparoscopic-assisted radical vaginal hysterectomy.MethodsCervical cancer patients, FIGO (International Federation of Gynecology and Obstetrics) stage IA2–IB1/IIA1 who submitted to nerve-sparing radical hysterectomy were recruited. Pelvic functions were assessed within 30 days (early outcome) and 12 months after surgery (long-term outcome).ResultsTwo hundred thirteen subjects receiving nerve-sparing radical hysterectomy were enrolled. Laparoscopic total mesometrial resection was performed in 46 patients (21.6%), total laparoscopic radical hysterectomy in 65 patients (30.5%), vaginal-assisted laparoscopic radical hysterectomy in 54 patients (25.4%), and laparoscopic-assisted radical vaginal hysterectomy in 48 women (22.5%). Operative time was significantly lower in the L-TMMR group (240 minutes; range, 120–670 minutes; P = 0.001). The overall perioperative complication rate was 11.3%, with no statistically significant differences among the 4 groups. Stress incontinence and sensation of bladder incomplete emptying were detected, respectively, in 54 patients (25.6%) and 65 patients (30.7%) with a significantly lower prevalence among those in the L-TMMR group, which resulted, respectively, in 11.1% (P = 0.022) and 13.3% (P = 0.036). The prevalence rates of constipation, sensation of incomplete bowel emptying, and effort during evacuation were significantly higher among those in the L-TMMR group, resulting in, respectively, 37% (P = 0.001), 42.3% (P = 0.012), and 50% (P = 0.039). One hundred forty-nine patients (70%) were sexually active. Fifty-eight women (38.9%) reported low enjoyment, 83 women (55.7%) medium enjoyment, and 8 women (5.4%) reported high enjoyment, without statistically significant differences among the 4 groups.ConclusionsLaparoscopic total mesometrial resection is associated with improved long-term urinary autonomic functions and worse gastrointestinal autonomic outcome. Further larger prospective trials are needed to evaluate both the oncological and functional outcomes in order to establish the most appropriate surgical approach for early-stage cervical cancer patients.

Robotic Uterine Artery Preservation and Nerve-Sparing Radical Trachelectomy With Bilateral Pelvic Lymphadenectomy in Early-Stage Cervical Cancer

2011 ◽  
Vol 21 (2) ◽  
pp. 391-396 ◽  
Author(s):  
Dae Gy Hong ◽  
Yoon Soon Lee ◽  
Nae Yoon Park ◽  
Gun Oh Chong ◽  
Il Soo Park ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Blood Loss ◽  
Uterine Artery ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Nerve Sparing ◽  
Radical Trachelectomy ◽  
Estimated Blood Loss ◽  
Early Stage Cervical Cancer ◽  
The Mean

Objective:The aim of the study was to evaluate the safety and feasibility of robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy using the da Vinci surgical system.Methods:Three patients who were diagnosed with early-stage cervical cancer underwent robotic uterine artery preservation and nerve-sparing radical trachelectomy with bilateral lymphadenectomy from January 2010 to March 2010. The data were compared with those of 4 cases of total laparoscopic nerve-sparing radical trachelectomy that were performed from July 2004 to May 2005 and were previously reported.Results:In the robotic group, the mean console time was 275 minutes (range, 240-305 minutes). The mean postoperative hemoglobin change was 0.4 g/dL (range, 0.2-0.6 g/dL). The mean estimated blood loss was 23 mL (range, 15-40 mL), which is less than that of the laparoscopic group. There were no metastases detected in any of the cases, and the resection margins were negative in both groups.Conclusions:The robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy were efficient in reducing blood loss and feasible methods such as other approaches.

Robotic Radical Parametrectomy for occult early stage cervical cancer

ASVIDE ◽  
2020 ◽  
Vol 7 ◽  
pp. 162-162
Author(s):  
Houssein El Hajj ◽  
Domenico Ferraioli ◽  
Mathilde Roussel ◽  
Camille Jauffret ◽  
Gilles Houvenaeghel ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Early Stage Cervical Cancer ◽  
Radical Parametrectomy

Early and late morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A prospective multicentric cohort of 232 patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17007-e17007
Author(s):  
Vincent Balaya ◽  
Léa Rossi ◽  
Charlotte Ngo ◽  
Anne-Sophie Bats ◽  
Patrice Mathevet ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Femoral Nerve ◽  
Pelvic Lymphadenectomy ◽  
Nerve Sparing ◽  
Node Biopsy ◽  
Urinary Infections ◽  
Late Morbidity ◽  
Early Stage Cervical Cancer

e17007 Background: The aim of this study was to assess the early and late post-operative morbidity of patients who have undergone a radical hysterectomy (RH) for early-stage cervical cancer. Methods: We retrospectively analyzed the data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II). Patients underwent a radical hysterectomy for early-stage cervical cancer between January 2005 and March 2012 in 23 French oncologic centers. Results: A total of 412 patients were enrolled and 284 had a radical hysterectomy. Data were complete for 232 patients: 115 by laparoscopic-assisted vaginal way, 80 patients by total laparoscopic way, 9 patients by total vaginal way, 22 patients by laparotomy and 6 patients by robot-assisted way. The median age was 44 years (range = 25-85 years). 89.6 % of patients had a stage IB1 disease. 72.4% were epidermoid carcinoma and 24.6% adenocarcinoma. Eighty-one patients (35%) had only a sentinel lymph node biopsy and 151 patients (65%) had an additional pelvic lymphadenectomy. There were 45 cases of urinary infections (19.4%), 17 cases of dysuria (7.3%), 10 cases of urinary incontinence (4.3%), and 6 cases of ureteral or vesical fistula (2.6%). The genito-femoral nerve was injured in 25 cases (10.7%) and the obturator nerve was injured in 22 cases (9.5%). There were 38 cases of limb lymphedema (16.3%) and 14 cases of pelvic lymphocyst (6%). Conclusions: These complications rates are similar with those found in the current literature. Urinary infections and limb lymphedema are the main complications of RH. The functional outcomes could be improved by applying nerve-sparing techniques. [Table: see text]

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