Comparison of laparoscopic-assisted radical vaginal hysterectomy and laparoscopic radical hysterectomy in the treatment of cervical cancer.
BACKGROUND
The aim of this study was to compare the surgical and oncologic outcomes of laparoscopic-assisted radical vaginal hysterectomy (LARVH) with that of laparoscopic radical hysterectomy (LRH) for early-stage cervical cancer.


METHODS
Patients affected by invasive cervical cancer (FIGO stage I-IIA) who had received LARVH (n = 89) in our institute between September 2004 and December 2010 were compared with patients treated by LRH (n = 105) during the same period. All patient information, surgical and pathological data, and oncological results were prospectively collected. Patients undergoing abdominal radical hysterectomy (ARH) were included for comparison of safety, morbidity, and recurrence rate.


RESULTS
The mean estimated blood loss (EBL) and return of bowel activity were significantly reduced in the LRH group compared with the LARVH group (p = .011 and p = .002, respectively). Intraoperative complications occurred in 10 patients (11.2 %) in the LARVH group, 6 (5.7 %) in the LRH group, and 3 (3.0 %) in the ARH group. Forest plot analyses of the previous studies showed higher incidence of intraoperative complication in the LARVH group than in LRH group (p = .02). Despite the similar overall recurrence rate, stump recurrence seems to be high in the LRH group in the forest plot analysis of previous studies (p = 0.08).


CONCLUSIONS
Both LARVH and LRH are safe and effective therapeutic procedures for the management of early-stage cervical cancer, although LRH is characterized by less blood loss and shorter bowel recovery time. Possible higher stump recurrence in the LRH should be further evaluated.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. chelhun.choi@samsung.com
Chel Hun
CH
Choi
Jeong-Won
JW
Lee
Yoo-Young
YY
Lee
Ha-Jeong
HJ
Kim
Taejong
T
Song
Min-Kyu
MK
Kim
Tae-Joong
TJ
Kim
Byoung-Gie
BG
Kim
Duk-Soo
DS
Bae
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*