[Preliminary study of nerve sparing radical hysterectomy in patients with cervical cancer].
OBJECTIVE
To assess the feasibility of nerve sparing radical hysterectomy (NSRH) technique and the impact on the improvement of postoperative bladder function in patients with cervical cancer.


METHODS
Forty-two patients with FIGO stage Ib1 approximately Ib2 cervical cancer were selected to receive NSRH (study group, 21 cases) or routine hysterectomy (RH) (control group, 21 cases). Duration of surgery, blood loss and mean length of postoperative stay were compared between the two groups. Immunohistochemical analysis of surgical margins using a general nerve marker (S-100) was performed to compare the nerve damages.


RESULTS
The operation time of NSRH group and RH group was (248 +/- 24) min and (227 +/- 27) min, respectively, with a significant difference between the two groups (P < 0.01). No significant difference in blood loss was found between the NSRH and RH group [(459 +/- 143) ml vs. (454 +/- 121) ml, P > 0.05]. However, the median urinary catheterization time was 7 days in NSRH group versus 16 days in the RH group, with a statistically significant difference between the two groups (P < 0.01). The rate of patients who had postoperative residual urine volume in bladder (PVR) < or =100 ml was 66.7% in the NSRH group versus 19.0% in the RH group, with a significant difference between the two groups (P < 0.01). No severe perioperative complications occurred in both groups. After a follow-up of 11 to 16 months (median: 14 months), no recurrence was detected in the two groups. Immunohistochemistry with S-100 staining revealed only small nerve fibers in the surgical margins of the NSRH group, but full with large nerve bundles in that of the RH group. There was a significant difference between two group (P < 0.01).


CONCLUSIONS
The results of our preliminary study indicate that nerve sparing radical hysterectomy (NSRH) for the patients with FIGO stage Ib1 approximately Ib2 cervical cancer is safe and feasible, and can well preserve the pelvic autonomic nerves and improve the recovery of bladder voiding function.
Sun
Li
L
Department of Gynecological Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Wu
Ling-ying
LY
Zhang
Wen-hua
WH
Li
Xiao-guang
XG
Song
Yan
Y
Zhang
Xun
X
D000328:Adult; D016063:Blood Loss, Surgical; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D009418:S100 Proteins / Q000378:metabolism; D001743:Urinary Bladder / Q000294:innervation* / Q000601:surgery; D014546:Urinary Catheterization; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*
D009418:S100 Proteins