[Clinical evaluation of laparoscopic radical hysterectomy with pelvic and para-aortic lymphadenectomy in patients with cervical cancer].

OBJECTIVE

To evaluate the effective, results and complications in patients with cervical cancer who consented to undergo laparoscopic radical hysterectomy and retroperitoneal lymphadenectomy.

METHODS

In 57 consecutive patients with stage Ia to IIb cervical cancer, laparoscopic radical hysterectomy and lymphadenectomy were performed. Forty-eight patients had squamous cell carcinomas, 7 patients had adenocarcinomas, and 2 patients had adenosquamous carcinomas of the cervix.

RESULTS

All but 2 surgical procedures were completed laparoscopically. The average operative time was 186 min (150 - 320 min). The average blood loss was 168 ml (120 - 700 ml). Average numbers of pelvic and paraaortic lymph nodes removed were 18.6 (12 - 23) and 8.2 (6 - 12), respectively. Eight patients (14.0%) had positive lymph nodes. All surgical margins were macroscopically negative. Operative cystotomies occurred in 2 patients and one patient with venous injuries were repaired laparoscopically. Two other patients underwent laparotomy to control bleeding or repair ascending colon. After surgery, patients passed gas in 2.3 days and self-voided in 10.2 days on average. Follow-up has been provided every 3 months. There have been 3 cases of recurrences, one patient uncontrolled, and one patient ureteral constriction. Three patients have retention of urine.

CONCLUSIONS

Laparoscopic radical hysterectomy and lymphadenectomy can be successfully completed in patients with cervical cancer with acceptable operation complications, a less injury and recovery time, and may become preferred for treating early cervical cancer.