title: Clinical evaluation of laparoscopic-assisted radical vaginal hysterectomy with pelvic and/or paraaortic lymphadenectomy.
abstract: 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.
authors.affiliation: 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.
authors.forename: Chong Taik
authors.initials: CT
authors.lastname: Park
authors.forename: Kyung Taek
authors.initials: KT
authors.lastname: Lim
authors.forename: Hwan Wook
authors.initials: HW
authors.lastname: Chung
authors.forename: Ki Heon
authors.initials: KH
authors.lastname: Lee
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: Jae Uk
authors.initials: JU
authors.lastname: Shim
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Kim
mesh_terms: 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*