Akusherstvo i ginekologiia · 2010
[Radical surgical treatment with nerve-sparing technique in early cervical cancer--stage IA-IIA. Our and foreign experience].
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Ivanov I
Аннотация
INTRODUCTION: We tried to make clear the role of sparing of the autonomous pelvic nerves during radical hysterectomy in cervical cancer stage IA-IIA. We compared the radicality, the possibility to introduce this type of operation, the level of local recurrence, the safety and the survival rate of these patients.
METHODS: We summarized 50 scientific publications in this field. We analyzed the level of local recurrence, survival rate and safety of this surgical technique.
RESULTS: The groups with or without nerve-sparing had comparable parameters and results. The sparing of the autonomous pelvic nerves from unilateral or bilateral part of the pelvis was possible in 70-85% of the patients. We found local recurrences in 5% without nerve-sparing operations and in 9,1% in radical hysterectomies with nerve sparing technique. Local recurrences in the group without sparing the nerve inervation appeared after 24 months, and in the group with nerve-sparing technique after 21 months. The duration of the operation and the blood loss were less in the group with nerve-sparing technique. The death and survival rate in both groups were equal.
CONCLUSIONS: As a result of our literature review and our own experience we consider that the sparing of the autonomous pelvic nerves in radical hysterectomies in early cervical cancer can be applied without problems and safely.
METHODS: We summarized 50 scientific publications in this field. We analyzed the level of local recurrence, survival rate and safety of this surgical technique.
RESULTS: The groups with or without nerve-sparing had comparable parameters and results. The sparing of the autonomous pelvic nerves from unilateral or bilateral part of the pelvis was possible in 70-85% of the patients. We found local recurrences in 5% without nerve-sparing operations and in 9,1% in radical hysterectomies with nerve sparing technique. Local recurrences in the group without sparing the nerve inervation appeared after 24 months, and in the group with nerve-sparing technique after 21 months. The duration of the operation and the blood loss were less in the group with nerve-sparing technique. The death and survival rate in both groups were equal.
CONCLUSIONS: As a result of our literature review and our own experience we consider that the sparing of the autonomous pelvic nerves in radical hysterectomies in early cervical cancer can be applied without problems and safely.