Total Laparoscopic Radical Hysterectomy (Piver Type II and III) in the Management of Early Stage of Cervical Cancer. Our Experience and First Reported Case Series from Turkey

Abstract

Study Objective: To describe feasibility and our experience of total laparoscopic radical hysterectomy with pelvic lymphadenectomy.Design: Prospective collected data evaluated retrospectively.Setting: University Hospital.Patients: Totally 20 cases with stage IA2 and IBI cervical cancer.Intervention: : Laparoscopic type II (n=8) or type III(n=12) radical hysterectomy with pelvic lymphadenectomy including common iliac and/or paraaortic lymphadenectomy.Monopolar, Bipolar coagulation, vascular clips and liga-sure vascular sailing system were used.Measurements and Main Results: Median age was 42. All patients had pelvic lymphadenectomy including common iliac and 4 cases paraaortic lymphadenectomy, respectively. Median pelvic lymph node number was 29 and 16 for paraaortic lymphadenectomy. Two(10%) cases had parametrial involvement, one of them with pelvic lymph node metastasis. Adjuvant radiation therapy was given to these cases. There were no recurrences median follow up 36 months. Two unit blood transfusion was given in one case. There were no intraoperative serious complications. Three cases need postoperative self catheterisation.Conclusion: According to this case series, laparoscopic radical total abdominal hysterectomy can be applied to surgical treatment of cervical cancer with low morbidity. Study Objective: To describe feasibility and our experience of total laparoscopic radical hysterectomy with pelvic lymphadenectomy. Design: Prospective collected data evaluated retrospectively. Setting: University Hospital. Patients: Totally 20 cases with stage IA2 and IBI cervical cancer. Intervention: : Laparoscopic type II (n=8) or type III(n=12) radical hysterectomy with pelvic lymphadenectomy including common iliac and/or paraaortic lymphadenectomy.Monopolar, Bipolar coagulation, vascular clips and liga-sure vascular sailing system were used. Measurements and Main Results: Median age was 42. All patients had pelvic lymphadenectomy including common iliac and 4 cases paraaortic lymphadenectomy, respectively. Median pelvic lymph node number was 29 and 16 for paraaortic lymphadenectomy. Two(10%) cases had parametrial involvement, one of them with pelvic lymph node metastasis. Adjuvant radiation therapy was given to these cases. There were no recurrences median follow up 36 months. Two unit blood transfusion was given in one case. There were no intraoperative serious complications. Three cases need postoperative self catheterisation. Conclusion: According to this case series, laparoscopic radical total abdominal hysterectomy can be applied to surgical treatment of cervical cancer with low morbidity.