Clinical evaluation of laparoscopic-assisted radical vaginal hysterectomy with pelvic and/or paraaortic lymphadenectomy.
OBJECTIVE
To report our experience with radical laparoscopic-assisted vaginal hysterectomy (LAVH) with bilateral pelvic and/or paraaortic lymphadenectomy.


METHODS
Retrospective review (Canadian Task Force classification III).


METHODS
University-affiliated hospital.


METHODS
Fifty-two women with invasive carcinoma of the cervix, stage Ib1, smaller than 3 cm.


METHODS
Radical LAVH with pelvic and/or paraaortic lymphadenectomy.


RESULTS
Total operating time ranged from 230 to 650 minutes (mean 380 min). Major surgical complications were two cases of ureter injury, two cases of ureteral stricture, and one case of hematoma at the cannula site. Two cases were converted to laparotomy due to incomplete hemostasis of the uterine artery and obturator vein. The mean hemoglobin decrement was 1.7 g/dl the day after operation. Thirty patients received blood transfusion (mean 1.8 pints). Average numbers of pelvic and paraaortic lymph nodes removed were 27.7 (range 9-63) and 22.1 (range 6-52), respectively. After surgery, patients passed gas in 2.2 days and self-voided in 18.4 days on average. One woman had pelvic recurrence at 26 months after surgery. One died from brain metastasis 10 months after surgery.


CONCLUSIONS
This technique is feasible for treatment of early cervical carcinoma. An experienced surgeon could shorten operating time and reduce complications.
Park
Chong Taik
CT
Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University, School of Medicine, 1-19, Mookjung-Dong, Chung-Ku, Seoul, Korea.
Lim
Kyung Taek
KT
Chung
Hwan Wook
HW
Lee
Ki Heon
KH
Seong
Seok Ju
SJ
Shim
Jae Uk
JU
Kim
Tae Jin
TJ
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*