V Chiantera1, G Vizzielli2, A Lucidi3, V Gallotta4, M Petrillo3, F Legge5, A Fagotti6, J Sehouli7, G Scambia8, M Z Muallem7. 1. 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. 2. 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. 3. 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. 4. Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. 5. Division of Minimally Invasive Gynaecological Surgery, St. Maria Hospital, University of Perugia, Terni, Italy. 6. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Miulli Hospital, Acquaviva delle Fonti, Italy. 7. Division of Gynecologic Oncology, Charitè University, Berlin, Germany. 8. Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy; Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
Abstract
OBJECTIVE: To analyze the feasibility of total mesometrial resection by laparoscopy (L-TMMR) in a multicentric series of early stage cervical cancer. METHOD: 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%). CONCLUSION: 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.
OBJECTIVE: To analyze the feasibility of total mesometrial resection by laparoscopy (L-TMMR) in a multicentric series of early stage cervical cancer. METHOD: We prospectively evaluated a consecutive series of cervical cancerpatients 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%). CONCLUSION: L-TMMR can be safely performed in selected cervical cancerpatients. Further larger prospective trials are needed to evaluate the oncological outcome of patients undergoing this surgical procedure.
Authors: Lu Wu; Diamantis I Tsilimigras; Katiuscha Merath; J Madison Hyer; Anghela Z Paredes; Rittal Mehta; Kota Sahara; Fabio Bagante; Eliza W Beal; Feng Shen; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2019-04-22 Impact factor: 3.452
Authors: Alexander Melamed; Daniel J Margul; Ling Chen; Nancy L Keating; Marcela G Del Carmen; Junhua Yang; Brandon-Luke L Seagle; Amy Alexander; Emma L Barber; Laurel W Rice; Jason D Wright; Masha Kocherginsky; Shohreh Shahabi; J Alejandro Rauh-Hain Journal: N Engl J Med Date: 2018-10-31 Impact factor: 91.245