title: [Feasibility of unilateral or bilateral nerve-sparing radical hysterectomy in patients with cervical cancer and evaluation of the post-surgery recovery of the bladder and rectal function].
abstract: OBJECTIVE
  To investigate the feasibility of unilateral or bilateral nerve-sparing radical hysterectomy and evaluate the recovery of bladder and bowel function postoperatively.
  
  
  METHODS
  From August 2008 to October 2009, sixty-one patients with cervical cancer stage Ib1 to IIa underwent radical hysterectomy (33 cases) and nerve-sparing radical hysterectomy (28 cases). Unilateral nerve-sparing radical hysterectomy was performed in 10 patients, and bilateral nerve-sparing radical hysterectomy (BNS) was performed in 18 patients. The data of operation time, blood loss, postoperative hospital stay days, residual urine volume, and postoperative complications were collected. The postoperative recovery of bladder and bowel function was evaluated.
  
  
  RESULTS
  There were no significant differences between nerve-sparing radical hysterectomy (NSRH) and radical hysterectomy (RH) groups in operation time [NSRH: (224.5 ± 40.0) min, RH: (176.4 ± 30.0 min)], blood loss [NSRH: (464.3 ± 144.0) ml, RH: (374.2 ± 138.7) ml], postoperative hospital stay days [NSRH: (8.4 ± 2.0) d, RH: (9.2 ± 1.8) d, and residual urine volume [NSRH: (64.8 ± 16.9) ml, RH: (70.6 ± 16.0) ml]. There were also no significant differences between UNSRH and BNSRH groups in operation time [UNSRH: (208.5 ± 28.5) min, BNSRH: (233.3 ± 43.1) min], blood loss [UNSRH: (440.0 ± 104.9) ml, BNSRH: (477.8 ± 162.90) ml], postoperative hospital stay days [UNSRH: 9.1 ± 1.8) d, BNSRH: (8.7 ± 2.1 d], and the residual urine volume [UNSRH: (68.3 ± 12.5) ml, BNSRH: (62.8 ± 20.0) ml]. There was a significant difference in the time of the Foley catheter removal between NSRH [(12.4 ± 5.2) d] and RH [(22.4 ± 9.7) d] groups. There was a significant difference in the time of the Foley catheter removal between UNSRH [(18.2 ± 3.6) d] and BNSRH [(9.1 ± 2.0) d] groups. During the postoperative 3 weeks follow-up, the patients in the NSRH group had a higher rate of satisfaction at urination and defecation (100%, 75%) than the RH group (54.5%, 24.2%).
  
  
  CONCLUSIONS
  UNSRH and BNSRH are safe and feasible techniques for early stage cervical cancer, and may significantly improve the recovery of bladder and rectal function.
authors.affiliation: Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhu
authors.forename: Ai-Jun
authors.initials: AJ
authors.lastname: Yu
authors.forename: Hua-Feng
authors.initials: HF
authors.lastname: Shou
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: Zhu
authors.forename: Zheng-Yan
authors.initials: ZY
authors.lastname: Yang
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.forename: Yong-Liang
authors.initials: YL
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis / Q000294:innervation* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D012007:Rectum / Q000502:physiology; D001743:Urinary Bladder / Q000294:innervation / Q000502:physiology* / Q000601:surgery; D014554:Urination / Q000502:physiology; D014555:Urination Disorders / Q000517:prevention & control; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*