Videolaparoscopic radical hysterectomy approach: a ten-year experience.
BACKGROUND
Because of the advancements in surgical techniques and laparoscopic instruments, total laparoscopic radical hysterectomy can now be performed for the treatment of uterine cervical carcinoma. We assessed the feasibility, complications, and survival rates of patients who underwent total laparoscopic radical hysterectomy with pelvic lymphadenectomy.


METHODS
We retrospectively collected data from the medical charts of 29 patients who had undergone surgery between 1998 and 2008. The following data were assessed: age, staging, histological type, number of lymph nodes retrieved, parametrial measures, operative time, length of hospital stay, surgical complications, and disease-free time.


RESULTS
The mean patient age was 37.07+/-10.45 years. Forty percent of the patients had previously undergone abdominal or pelvic surgeries. Mean operative time was 228.96+/-60.41 minutes, and mean retrieved lymph nodes was 16.9+/-8.12. All patients had free margins. No conversions to laparotomy were necessary. Median time until hospital dismissal was 6.5 days (range 3-38 days). Four patients had intraoperative complications: 2 lacerations of the rectum, 1 laceration of the bladder, and 1 lesion of the ureter. Three patients developed bladder or ureteral fistulas postoperatively that were successfully corrected surgically.


CONCLUSIONS
Laparoscopic radical hysterectomy is feasible and has acceptable complications. The radicalism of the surgery must be considered, bearing in mind the parametrial measures and the number of lymph nodes retrieved.
Campos
Luciana Silveira
LS
Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil. dlu@terra.com
Limberger
Leo Francisco
LF
Kalil
Antonio Nocchi
AN
de Vargas
Gabriel Sebastião
GS
Damiani
Paulo Agostinho
PA
Haas
Fernanda Feltrin
FF
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D011183:Postoperative Complications; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000379:methods*