title: Our Experience of Laparoscopic Anterior Exenteration in Locally Advanced Cervical Carcinoma.
abstract: OBJECTIVE
  To show the feasibility, technique, and results of laparoscopic anterior exenteration in selected patients.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Galaxy Care Laparoscopy Institute, Pune, India.
  
  
  METHODS
  Seventy-four of 85 patients who underwent laparoscopic anterior exenteration for stage IVA carcinoma of the cervix from January 2005 to January 2015 were analyzed; the median follow-up was 30 months. Contrast-enhanced computed tomographic imaging of the abdomen and pelvis was performed for all patients.
  
  
  METHODS
  The same surgeon and team performed all the operations for uniformity in 10 operative steps.
  
  
  RESULTS
  The mean operative time was 180 minutes, and the mean blood loss was 160 mL. The mean hospital stay was 6 days. The average number of lymph nodes removed was 21.4. Surgical margins were negative in all patients. Forty-two patients had positive lymph nodes. Chemoradiation was given to those with positive lymph nodes. Perioperative complications occurred in 15 (20.27%) patients including deep vein thrombosis, urinary tract infection, ureterosigmoid leak (n = 2/74), and so on. Positron emission tomographic imaging and computed tomographic scanning were performed at 6 months after surgery and 6 months after adjuvant therapy in those with positive lymph nodes. There was no immediate postoperative mortality. The overall survival rate at 5 years was 25%.
  
  
  CONCLUSIONS
  Laparoscopic anterior exenteration is feasible in cases of advanced carcinoma of the cervix. Results have shown that in selected patients this procedure is associated with good long-term survival.
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India. Electronic address: shase63@gmail.com.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Puntambekar
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Vikrant
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Maharashtra University of Health Science, Nashik, India.
authors.forename: Arun V
authors.initials: AV
authors.lastname: Jamkar
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Yamini
authors.initials: Y
authors.lastname: Gadkari
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Joshi
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Puntambekar
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Hirav
authors.initials: H
authors.lastname: Parikh
authors.affiliation: Galaxy Care Laparoscopy Institute, Pune, India.
authors.forename: Shivam
authors.initials: S
authors.lastname: Vatsal
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000295:instrumentation / Q000379:methods; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: Advanced carcinoma cervix; Laparoscopic anterior exenteration; Palliation; Ureterosigmoidostomy