title: Laparoscopic radical hysterectomy in cervical cancer as total mesometrial resection (L-TMMR): a multicentric experience.
abstract: OBJECTIVE
  To analyze the feasibility of total mesometrial resection by laparoscopy (L-TMMR) in a multicentric series of early stage cervical cancer.
  
  
  METHODS
  We prospectively evaluated a consecutive series of cervical cancer patients with pre-operative FIGO stages IA2-IB1 at the Catholic University in Rome and in Campobasso and the Charitè University in Berlin. All cases were assessed at pre-operative MRI scan and clinically confirmed by investigation under anesthesia, adhering strictly to the FIGO criteria. The surgical and post-surgical data were collected.
  
  
  RESULTS
  104 women with cervical cancer were admitted between July 2013 and August 2014 and among them 71 patients with pre-operative FIGO stages IA2-IB1 were treated with L-TMMR. One laparotomic conversion was registered. The median operative time was 260min (120-670min), estimated blood loss was 100cm(3) (25-900cm(3)), and the median length of hospital stay was 6days (2-26days). We observed 8 intra-operative complications including a vascular injury of the left internal iliac vein that caused conversion, 6 vesical injuries and 1 ureteral injury managed laparoscopically. Two vescico-vaginal fistula and one hemoperitoneum were observed as major post-operative complications (4.2%).
  
  
  CONCLUSIONS
  L-TMMR can be safely performed in selected cervical cancer patients. Further larger prospective trials are needed to evaluate the oncological outcome of patients undergoing this surgical procedure.
authors.affiliation: Division of Gynecologic Oncology, Foundation "Giovanni Paolo II", University of Molise, Campobasso, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy; Division of Gynecologic Oncology, Charitè University, Berlin, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Chiantera
authors.affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy. Electronic address: giuseppevizzielli@yahoo.it.
authors.forename: G
authors.initials: G
authors.lastname: Vizzielli
authors.affiliation: Division of Gynecologic Oncology, Foundation "Giovanni Paolo II", University of Molise, Campobasso, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lucidi
authors.affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Division of Gynecologic Oncology, Foundation "Giovanni Paolo II", University of Molise, Campobasso, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Petrillo
authors.affiliation: Division of Minimally Invasive Gynaecological Surgery, St. Maria Hospital, University of Perugia, Terni, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Legge
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Miulli Hospital, Acquaviva delle Fonti, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Division of Gynecologic Oncology, Charitè University, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Sehouli
authors.affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Division of Gynecologic Oncology, Charitè University, Berlin, Germany.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Muallem
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 / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Cervical Cancer; Laparoscopy; Total Mesometrial Resection (TMMR)