Comparative study of laparoscopically assisted radical vaginal hysterectomy and open Wertheim-Meigs in patients with early-stage cervical cancer: eleven years of experience.
BACKGROUND
The aim of this study was to compare the feasibility, safety, and survival outcomes of Coelio-Schauta (CS) procedure versus open Wertheim-Meigs (WM) as primary surgical treatment of early-stage cervical cancer.


METHODS
Observational study on the consecutive cases of cervical cancer undergoing CS during the last 11 years at our institution was performed. Data on clinical characteristics of patients, surgical performance, long-term morbidity, and survival were prospectively analyzed and compared with a historical series of 23 consecutive WM performed at the same hospital in the immediate previous period.


RESULTS
Sixty-seven patients were included in the study group (CS). Cases and controls were comparable in age, body mass index, stage, tumor size, and histological diagnosis. The number of pelvic nodes, disease-free margin, and complications rate were similar in both groups, but blood loss and blood transfusion rate were marginally less in the CS group. Operating time was longer in the first 20 CS patients, but it became comparable to WM once the learning curve was overcome. Hospital stay was significantly shorter in the CS group as well as the bladder function recovery time. However, no differences were seen regarding long-term urinary and bowel function between groups. Four patients (5.9%) from the CS group and 3 (13%) in the WM group had recurrence. Mortality rates were 3% and 8.7%, respectively (P = not significant).


CONCLUSIONS
The CS procedure is a suitable alternative to WM for small-volume, early-stage cervical cancer, showing a good safety profile, shorter postoperative recovery time, and similar survival outcomes.
Sección de Ginecología Oncológica. Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08036 Barcelona, Spain.
Jaume
J
Pahisa
Sergio
S
Martínez-Román
Aureli
A
Torné
Pere
P
Fusté
Inmaculada
I
Alonso
Jose Antonio
JA
Lejárcegui
Joan
J
Balasch
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*