Safety and efficacy of a modified technique of laparoscopic radical hysterectomy for cervical cancer

J Obstet Gynaecol Res. 2022 Nov;48(11):2879-2887. doi: 10.1111/jog.15407. Epub 2022 Sep 4.

Abstract

Aim: Objective to investigate the feasibility, safety, and short-term efficacy of laparoscopic radical hysterectomy without uterine lifter combined with self-locking nylon band.

Methods: The clinical data of 152 patients who underwent a laparoscopic radical hysterectomy in the Department of gynecology and oncology of Changzhou maternal and child health hospital from January 2017 to June 2020 were analyzed retrospectively, including 97 patients who used uterine lifter (traditional laparoscopic radical hysterectomy) and 55 patients who underwent operation without uterine lifter but combining with self-locking nylon band (modified laparoscopic radical hysterectomy). The differences in operation time, intraoperative blood loss, the width of excised parauterine tissue, the length of the excised vaginal wall, postoperative pathology and short-term prognosis between the two groups were compared and analyzed.

Results: There were no significant differences between the two groups in operation time, intraoperative blood loss, the width of parauterine tissue, and the length of the vaginal wall (p > 0.05). There were no significant differences in the number of lymph nodes, pelvic lymph node metastasis rate and depth of cervical interstitial infiltration between the two groups (p > 0.05), the infiltration rate of lymphatic vascular space in the traditional group was higher than that in the improved group (p < 0.05).

Conclusion: It is feasible and safe for laparoscopic radical hysterectomy without uterine lifter combining with a self-locking nylon band to seal the vaginal wall. The uterine lifter may lead to lymphatic vascular space infiltration of tumor cells.

Keywords: cervical cancer; laparoscopy; uterine lifting; vaginal sealing.

MeSH terms

  • Blood Loss, Surgical
  • Child
  • Female
  • Humans
  • Hysterectomy / methods
  • Laparoscopy* / methods
  • Lymph Node Excision / methods
  • Neoplasm Staging
  • Nylons
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Cervical Neoplasms* / pathology

Substances

  • Nylons