Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: Pilot data and comparison to laparotomy Journal Article
| Authors: | Abu-Rustum, N. R.; Gemignani, M. L.; Moore, K.; Sonoda, Y.; Venkatraman, E.; Brown, C.; Poynor, E.; Chi, D. S.; Barakat, R. R. |
| Article Title: | Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: Pilot data and comparison to laparotomy |
| Abstract: | Objectives. The aim of this study was to describe the feasibility and outcome of total laparoscopic radical hysterectomy with pelvic lymphadenectomy for stage I cervical cancer using the argon-beam coagulator. Methods. A retrospective review was performed of patients with FIGO stage IA1-IB1 cervical cancer who underwent a total laparoscopic approach for definitive surgical treatment. Comparison was made to a cohort of 195 patients who were treated with laparotomy. Results. Between 12/2000 and 12/2002, 19 patients were offered the laparoscopic approach. The procedure was completed laparoscopically in 17 patients (89.5%). Two patients, in the beginning of the study, underwent conversion to laparotomy, 1 due to parametrial bleeding and 1 due to pelvic adhesions and cystotomy. Mean age was 42.6 years (range, 30-69 years); mean body mass index was 23.1 (range, 18-30); FIGO stage included IA1 with LVI (2), IA2 (6), IB1 (11). Mean pelvic lymph node count was 25.5 (range, 15-39), and 1 patient (5.3%) had positive nodes. Mean estimated blood loss was 301 cc (range, 75-1500 cc) compared to 693 cc in the laparotomy group (P < 0.01), mean operating time was 371 min (range, 230-600 min) compared to 295 min in the laparotomy group (P < 0.01), and mean hospital stay was 4.5 days (range, 3-11 days) compared to 9.7 days in the laparotomy group (P < 0.01). There were no ureteral injuries or fistula formation. All patients remain clinically disease free at the time of this report. Conclusions. Total laparoscopic radical hysterectomy with pelvic lymphadenectomy for selected patients with stage I cervical cancer is feasible, safe, and associated with a low morbidity in the pilot phase. Estimated blood loss and postoperative hospitalization appear shorter than historical controls, at the cost of longer operating time. Oncologic outcome requires longer follow-up. © 2003 Elsevier Inc. All rights reserved. |
| Keywords: | adult; controlled study; human tissue; treatment outcome; aged; middle aged; cancer surgery; surgical technique; retrospective studies; major clinical study; cancer staging; hysterectomy; laparoscopy; laparotomy; lymph node excision; cohort studies; pelvis lymphadenectomy; cohort analysis; surgical approach; retrospective study; postoperative complication; hospitalization; body mass; pilot study; lymph node; operation duration; intermethod comparison; postoperative hemorrhage; blood volume; uterine cervical neoplasms; radical hysterectomy; uterine cervix carcinoma; laser coagulation; laser; ureter injury; argon; humans; human; female; priority journal; article; coagulating agent; ureter fistula |
| Journal Title: | Gynecologic Oncology |
| Volume: | 91 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2003-11-01 |
| Start Page: | 402 |
| End Page: | 409 |
| Language: | English |
| DOI: | 10.1016/s0090-8258(03)00518-3 |
| PUBMED: | 14599873 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Erratum/Corrigendum issued, see DOI: 10.1016/j.ygyno.2004.01.002 -- Export Date: 12 September 2014 -- Source: Scopus |
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