A comparison of radical vaginal hysterectomy combined with extraperitoneal or laparoscopic pelvic lymphadenectomy in the treatment of cervical cancer.

Abstract

The use of radical vaginal hysterectomy in the treatment of cervical cancer is associated with lower morbidity and a similar cure rate when compared with the abdominal approach. The present study reports a case series of radical vaginal hysterectomy followed by extraperitoneal (Mitra) or video-laparoscopic (VLP) lymphadenectomy, with comparison of the 2 techniques. Twenty-five patients with cervical carcinoma (stages IA1 to IIA) were submitted to radical vaginal hysterectomy and extraperitoneal or laparoscopic lymphadenectomy. The Mitra technique was used in 17 cases, and VLP was used in 8. Seventeen patients presented minor postoperative complications. The number of resected lymph nodes was similar with both techniques (median of 14 with VLP vs. 21 with Mitra) (P = 0.215). The duration of surgery in the VLP group (mean, 339 minutes) was shorter than that of the Mitra group (mean, 421 minutes) (P = 0.015). The results obtained with both techniques are similar to those reported in the literature. The duration of extraperitoneal lymphadenectomy was longer than that of VLP lymphadenectomy. There were no differences between the 2 techniques concerning the number of resected lymph nodes and hospital stay.