Laparoscopy versus Laparotomy for Radical Hysterectomy
From July 1993 to March 1996 we performed 62 radical hysterectomies, 15 (24.2%) by laparoscopy and 47 (75.8%) by laparotomy. All patients had cervical carcinoma FIGO stages Ia2 and Ib1. We compared the duration of surgery, blood loss, number of pelvic nodes obtained, surgical margins, and complications. The average duration of laparoscopic surgery was 4.5 hours versus 3 hours for laparotomy. Blood loss at laparoscopy was 250 ml, and 600 ml at laparotomy. The number of pelvic nodes obtained by laparotomy was 24.74 and by laparoscopy an average of 25. In all cases the surgical margins were free of tumors. Two complications in the laparoscopy group were a vaginal hematoma and a ureteral injury. At laparotomy one ureteral fistula occurred. No difference between approaches in pathology specimens were seen. Blood loss was lower at laparoscopy but the duration of surgery was longer. Radical hysterectomy by laparoscopy seems safe and effective.
Vidal
O
University Hospital, Madero Y Gonzalitos S/N, Monterrey, N.L. Mexico C.P. 64460.
Garza-Leal
JG