S Malur1, M Possover, A Schneider. 1. Department of Gynecology, Friedrich-Schiller University, Bachstrasse 18, 07740 Jena, Germany.
Abstract
BACKGROUND: In a retrospective study, we compared a laparoscopic radical vaginal approach with abdominal radical hysterectomy type II for treatment of patients with cervical cancer at International Federation of Gynecology and Obstetrics (FIGO) stages I to III. METHODS: Between January 1991 and March 1994, 70 patients with cervical cancer were treated by radical abdominal hysterectomy, and between August 1994 and May 1999, 70 patients with cervical cancer were treated by laparoscopically assisted radical vaginal hysterectomy. Data from both the abdominal group and the laparoscopic-vaginal group were obtained retrospectively. RESULTS: The mean duration of surgery was significantly longer for the laparoscopic-vaginal approach than for the abdominal approach (292.9 vs 209.9 min). Significantly more pelvic lymph nodes were removed by laparoscopy (27 vs 10.7). Blood loss and transfusion rates were significantly lower in the laparoscopic-vaginal group. Intraoperative complications were seen more often during laparoscopic-vaginal surgery (p < 0.05). Early postoperative complications occurred significantly more frequently after the abdominal approach. The mean duration of hospital stay was significantly shorter for patients treated by laparoscopic-vaginal surgery (11.4 vs 22.8 days). CONCLUSION: Compared with laparotomy, the laparoscopic-vaginal approach for treatment of cervical cancer is associated with lower rates of transfusion and early postoperative morbidity.
BACKGROUND: In a retrospective study, we compared a laparoscopic radical vaginal approach with abdominal radical hysterectomy type II for treatment of patients with cervical cancer at International Federation of Gynecology and Obstetrics (FIGO) stages I to III. METHODS: Between January 1991 and March 1994, 70 patients with cervical cancer were treated by radical abdominal hysterectomy, and between August 1994 and May 1999, 70 patients with cervical cancer were treated by laparoscopically assisted radical vaginal hysterectomy. Data from both the abdominal group and the laparoscopic-vaginal group were obtained retrospectively. RESULTS: The mean duration of surgery was significantly longer for the laparoscopic-vaginal approach than for the abdominal approach (292.9 vs 209.9 min). Significantly more pelvic lymph nodes were removed by laparoscopy (27 vs 10.7). Blood loss and transfusion rates were significantly lower in the laparoscopic-vaginal group. Intraoperative complications were seen more often during laparoscopic-vaginal surgery (p < 0.05). Early postoperative complications occurred significantly more frequently after the abdominal approach. The mean duration of hospital stay was significantly shorter for patients treated by laparoscopic-vaginal surgery (11.4 vs 22.8 days). CONCLUSION: Compared with laparotomy, the laparoscopic-vaginal approach for treatment of cervical cancer is associated with lower rates of transfusion and early postoperative morbidity.