title: Feasibility, morbidity, and safety of total laparoscopic radical hysterectomy with lymphadenectomy: our experience.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate, in a series of 65 patients, the feasibility, morbidity, and safety of total laparoscopic radical hysterectomy with lymphadenectomy for early cervical carcinoma.
  
  
  METHODS
  Retrospective, nonrandomized study (Canadian Task Force classification II-2).
  
  
  METHODS
  Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy.
  
  
  METHODS
  Sixty-five nonconsecutive patients with International Federation of Gynecology and Obstetrics (FIGO) stage Ia1 with lymphvascular space involvement, Ia2, and Ib1 early cervical cancer.
  
  
  METHODS
  Fourteen patients underwent a laparoscopic class II procedure, and 51 patients underwent a class III procedure according to the Piver classification. All the patients underwent total laparoscopic radical hysterectomy with pelvic lymphadenectomy during the study period, and none of the surgeries required conversion to laparotomy. Paraaortic lymphadenectomy is not routinely performed unless suspicious pelvic lymph nodes are confirmed to have metastatic disease on frozen section evaluation.
  
  
  RESULTS
  Fifty-six patients had squamous cell carcinoma; 7 patients had adenocarcinomas, and 2 had adenosquamous carcinoma. The mean age was 40.5 years (95% CI 27.7-69.1) and the SD was +/- 7.5. The median weight was 56.2 kg (range 44-75 kg). The median operative time was 196 minutes (range 182-240 minutes), and the surgical margins were free of disease in all cases. The median blood loss was 55 mL (range 30-80 mL). No patient required an intraoperative blood transfusion. The median length of hospital stay was 4 days (range 3-7 days).
  
  
  CONCLUSIONS
  Laparoscopic treatment of cervical cancer offers patients the potential benefits of decreased discomfort with decreased convalescence time, but it should be reserved for oncologic surgeons trained in extensive laparoscopic procedures.
authors.affiliation: Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Malzoni
authors.forename: Raffaele
authors.initials: R
authors.lastname: Tinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Cosentino
authors.forename: Ciro
authors.initials: C
authors.lastname: Perone
authors.forename: Vincenza
authors.initials: V
authors.lastname: Vicario
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000601:surgery*