title: Nerve-sparing minilaparoscopic versus conventional laparoscopic radical hysterectomy plus systematic pelvic lymphadenectomy in cervical cancer patients.
abstract: OBJECTIVE
  To present our preliminary experience with nerve-sparing minilaparoscopic radical hysterectomy plus pelvic lymphadenectomy for the surgical treatment of cervical cancer and to compare outcomes with those of the conventional laparoscopic approach.
  
  
  METHODS
  Data of 87 consecutive women who underwent minimally invasive surgery for early and locally advanced stage cervical cancer were prospectively collected. Ten women who underwent laparoscopic surgery using a nerve-sparing technique performed through 3-mm ancillary ports were compared with the 77 patients who had standard laparoscopic surgery previously with 3 sovrapubic 5-mm trocars.
  
  
  RESULTS
  Minilaparoscopic radical hysterectomy was successfully accomplished in every case with no conversion to standard laparoscopy or open surgery. Two (2.6%) conversions to open surgery occurred in the conventional laparoscopy group. Surgical characteristics (operative time, estimated blood loss, and length of stay) and complication rate were similar between the 2 groups. No differences in the amount of parametrial and vaginal tissue removed were observed. The number of lymph nodes retrieved through minilaparoscopy was higher than conventional laparoscopy (30 [range = 26-38] vs 22 [range = 8-49]; P = .002). However, no difference was observed when the analysis was restricted to the last 10 conventional procedures (30 [range = 26-38] vs 29 [range = 24-49]; P = .81).
  
  
  CONCLUSIONS
  Our data show that minilaparoscopic radical hysterectomy with pelvic lymphadenectomy is a feasible procedure if performed by skilled surgeons.
authors: 1University of Insubria, Del Ponte Hospital, Varese, Italy.
authors: Fabio
authors: F
authors: Ghezzi
authors: Antonella
authors: A
authors: Cromi
authors: Stefano
authors: S
authors: Uccella
authors: Giorgio
authors: G
authors: Bogani
authors: Davide
authors: D
authors: Sturla
authors: Maurizio
authors: M
authors: Serati
authors: Pierfrancesco
authors: P
authors: Bolis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000601:surgery*
keywords: cervical cancer; laparoscopy; minilaparoscopy; needlescopic surgery; nerve sparing; radical hysterectomy