title: Laparoscopic nerve-sparing radical parametrectomy for occult early-stage invasive cervical cancer after simple hysterectomy.
abstract: OBJECTIVE
  To investigate the feasibility and surgical outcomes of laparoscopic nerve-sparing radical parametrectomy (LNSRP) and lymphadenectomy for treatment of occult early-stage invasive cervical cancer after simple hysterectomy.
  
  
  METHODS
  From 2006 to 2010, 28 patients who were discovered to have occult early-stage invasive cervical cancer after a simple hysterectomy underwent LNSRP, upper vaginal resection, and pelvic lymphadenectomy. A retrospective analysis of these cases was performed.
  
  
  RESULTS
  All patients underwent successful LNSRP. There was no conversion to laparotomy. The mean ± SD operation time was 173.30 ± 56.20 minutes. The mean ± SD estimated blood loss was 230.00 ± 109.55 mL. Two intraoperative complications were recorded. The median number of extracted pelvic and para-aortic lymph nodes was 23 (range, 12-36) and 7 (range, 3-15), respectively. The mean ± SD time before Foley catheter removal was 5.6 ± 2.74 days (range, 3-14 days ), and bladder voiding function recovery to grade 0 to grade 1 was observed in 26 patients (92.9%). Of the 28 patients, 3 patients received further adjuvant therapy. The median follow-up period was 38 (range, 4-62) months for all patients. No recurrence case was found in this series.
  
  
  CONCLUSIONS
  Laparoscopic nerve-sparing radical parametrectomy is a therapeutic option for occult early-stage invasive cervical cancer discovered after hysterectomy. Nerve-sparing radical surgery in indicated patients may lead to optimal preservation of bladder function.
authors.affiliation: Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, PR China.
authors.forename: Junnan
authors.initials: J
authors.lastname: Li
authors.forename: Huicheng
authors.initials: H
authors.lastname: Xu
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Wang
authors.forename: Yuyan
authors.initials: Y
authors.lastname: Li
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Liang
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002584:Cervix Uteri / Q000294:innervation* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery