Radical Hysterectomy: Efficacy and Safety in the Dawn of Minimally Invasive Techniques

Antonio Gil-Moreno, Melchor Carbonell-Socias, Sabina Salicrú, Cristina Centeno-Mediavilla, Silvia Franco-Camps, Eva Colas, Ana Oaknin, Assumpció Pérez-Benavente, Berta Díaz-Feijoo

Research output: Contribution to journalArticleResearch

17 Citations (Scopus)

Abstract

© 2018 AAGL Study Objective: To analyze the effect that the introduction of minimally invasive procedures has had on surgical and oncologic outcomes when compared with conventional open radical hysterectomy (ORH) in a national reference cancer after 17 years of experience in radical hysterectomy. Design: A prospective controlled study (Canadian Task Force classification II-2). Setting: A university teaching hospital. Patients: All patients who underwent radical hysterectomy as primary treatment for cervical cancer in our institution between May 1999 and June 2016, with a total of 188 patients. Interventions: Patients underwent ORH or minimally invasive surgery (MIS) (i.e., laparoscopic or robotically assisted radical hysterectomy). Measurements and Main Results: Seventy-six patients underwent ORH, 90 laparoscopic radical hysterectomy, and 22 robotically assisted radical hysterectomy. Blood loss and hospital stay were inferior in the MIS group (p <.0001). The laparotomic group presented shorter operation times (p =.0001). With a median follow-up of 112.4 months, a total of 156 patients (83%) were alive and free of disease at the time of the data analysis. Overall survival was higher in the MIS group when compared with the ORH group (91 vs 78.9, p =.026). There were no differences regarding recurrence rates between the surgical approaches. Conclusion: With 1 of the largest follow-up periods in the literature, this study provides added evidence that MIS could become the preferable surgical approach for early-stage cervical cancer since it appears to reduce morbidity without affecting oncologic results.
Original languageEnglish
Pages (from-to)492-500
JournalJournal of Minimally Invasive Gynecology
Volume26
DOIs
Publication statusPublished - 1 Mar 2019

Keywords

  • Cervical cancer
  • Laparoscopy
  • Nerve sparing
  • Robotic surgery
  • Survival

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