Laparoscopic lymphadenectomy and vaginal radical hysterectomy for the treatment of cervical cancer

Abstract

The choice of treatment (surgery, radiotherapy) for cervical carcinoma depends on surgical staging. The noninvasive approach for node evaluation is not very accurate; therefore lymph node metastasis has to be determined surgically. Seventeen women with cervical cancer underwent bilateral laparoscopic lymphadenectomy with dissection of the common iliac, hypogastric, and external iliac vessels and the obturator nerve. The average number of lymph nodes sampled was 14 (range 12-24 nodes). The mean duration of lymphadenectomy was 60 minutes (range 50-90 min). Based on preoperative evaluation and on the pathology report, a radical vaginal hysterectomy (Schauta-Amreich) was performed in all women at the end of laparoscopy. All laparoscopies and radical hysterectomies were uneventful. Based on this preliminary experience, laparoscopic lymphadenectomy may play an important role in reviving radical vaginal hysterectomy in women with cervical cancer. Followed by vaginal radical hysterectomy, it may be the treatment of choice in early disease, avoiding an abdominal incision.