TY - JOUR
T1 - Radical Hysterectomy: Efficacy and Safety in the Dawn of Minimally Invasive Techniques
AU - Gil-Moreno, Antonio
AU - Carbonell-Socias, Melchor
AU - Salicrú, Sabina
AU - Centeno-Mediavilla, Cristina
AU - Franco-Camps, Silvia
AU - Colas, Eva
AU - Oaknin, Ana
AU - Pérez-Benavente, Assumpció
AU - Díaz-Feijoo, Berta
PY - 2019/3/1
Y1 - 2019/3/1
N2 - © 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.
AB - © 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.
KW - Cervical cancer
KW - Laparoscopy
KW - Nerve sparing
KW - Robotic surgery
KW - Survival
KW - Length of Stay
KW - Prospective Studies
KW - Neoplasm Recurrence, Local/mortality
KW - Humans
KW - Middle Aged
KW - Hospitals, University
KW - Hysterectomy/methods
KW - Spain
KW - Operative Time
KW - Adenocarcinoma/mortality
KW - Minimally Invasive Surgical Procedures/methods
KW - Uterine Cervical Neoplasms/mortality
KW - Survival Analysis
KW - Adult
KW - Carcinoma, Squamous Cell/mortality
KW - Female
KW - Aged
KW - Neoplasm Staging
KW - Postoperative Complications
UR - http://www.mendeley.com/research/radical-hysterectomy-efficacy-safety-dawn-minimally-invasive-techniques
UR - https://www.scopus.com/pages/publications/85050798601
U2 - 10.1016/j.jmig.2018.06.007
DO - 10.1016/j.jmig.2018.06.007
M3 - Article
C2 - 29908339
SN - 1553-4650
VL - 26
SP - 492
EP - 500
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
ER -
ODS 3: Salud y bienestar