title: Total laparoscopic radical hysterectomy (type II-III) with pelvic lymphadenectomy in early invasive cervical cancer.
abstract: OBJECTIVE
  To describe the feasibility and outcome of total laparoscopic radical hysterectomy with pelvic lymphadenectomy in early cervical cancer.
  
  
  METHODS
  Retrospective, nonrandomized study (Canadian Task Force classification II-2).
  
  
  METHODS
  Acute-care, teaching hospital.
  
  
  METHODS
  Twenty-seven nonconsecutive patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 (n = 4) or IB1 (n = 23) cancer of the cervix.
  
  
  METHODS
  Laparoscopic type II (n = 9) or type III (n = 18) hysterectomy with systematic bilateral pelvic lymphadenectomy. Monopolar coagulation, vascular clips, and harmonic scalpel were used. Resection of the cardinal and uterosacral ligaments was performed with Endo GIA stapling and the harmonic scalpel.
  
  
  RESULTS
  Histopathologically, there were 20 cases of squamous carcinoma, 6 adenocarcinomas, and 1 adenosquamous carcinoma. The operation was performed entirely by laparoscopy in 26 patients. One patient underwent laparotomy because of equipment failure. The patients' mean age was 45.1 years (95% CI 41.7-48.4), with a median body mass index of 26.0 kg/m2. The mean number of resected pelvic nodes was 19.1 (95% CI 17.02-21.2). Three patients had microscopic metastatic nodal disease. The surgical margins were free of disease in all cases. The median blood loss was 400 mL (range 250-700 mL). The median length of stay was 5 days. Major intraoperative complications did not occur. All patients are free of disease after a median follow-up of 32 months (range 4-52 months).
  
  
  CONCLUSIONS
  Radical hysterectomy can be successfully completed by laparoscopy in patients with early cervical cancer. This procedure may reduce the morbidity associated with abdominal or transvaginal radical hysterectomy.
authors.affiliation: Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Maternal-Infant Hospital Vall d'Hebron, Barcelona, Spain. antonioimma@yahoo.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Moreno
authors.forename: Oriol
authors.initials: O
authors.lastname: Puig
authors.forename: María A
authors.initials: MA
authors.lastname: Pérez-Benavente
authors.forename: Berta
authors.initials: B
authors.lastname: Díaz
authors.forename: Ramona
authors.initials: R
authors.lastname: Vergés
authors.forename: Javier
authors.initials: J
authors.lastname: De la Torre
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez-Palones
authors.forename: Jordi
authors.initials: J
authors.lastname: Xercavins
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013030:Spain; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*