A Retrospective Comparison of the Outcomes of Laparoscopic and Open Radical Hysterectomy for Early and Advanced Cancer o
- PDF / 505,208 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 64 Downloads / 203 Views
ORIGINAL ARTICLE
A Retrospective Comparison of the Outcomes of Laparoscopic and Open Radical Hysterectomy for Early and Advanced Cancer of the Cervix, in the Post-LACC Era Subbiah Shanmugam1,2 Rajiv Michael1,2
•
Sujay Susikar1,2 • Syed Afroze Hussain1,2 • T. Bharanidharan1,2
•
Received: 31 July 2020 / Accepted: 9 November 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Laparoscopic radical hysterectomy (LRH) is being performed for cervical cancer treatment in many centres worldwide for last three decades. Since the results of LACC trial came out, a number of centres are reverting back to conventional open radical hysterectomy. In this study, we compared the surgical and oncological outcomes of LRH and ORH performed in our centre. Patients and methods This is a retrospective study in which we included 171 cancer cervix patients who underwent LRH or ORH in our centre from December 2012 to march 2018. We included FIGO (2009 edition) stages IB1 to IIB cervical cancer. Patients with stages IB2, IIA2 and IIB received neo-adjuvant therapy with either chemotherapy alone or concurrent chemoradiotherapy. Their demography, surgical morbidity, recurrence and survival data were collected and analysed. The survival data for patients who had upfront surgery and those with surgery after neo-adjuvant therapy were compared separately. Results There was significant difference between the two arms only in the estimated blood loss during surgery (p = 0.03). The duration of surgery, post-operative length of hospital stay and lymph node harvest were similar between LRH and ORH. The incidence of intraoperative bladder injuries (p = 0.1) and post-operative vesico-vaginal and uretero-vaginal fistulas were higher (p = 0.3) in LRH; there was no statistical significance. There was a non-significant increase in the postoperative bladder dysfunction rates in the LRH arm. The progression-free survival and overall survival were similar (both in upfront surgery and surgery after neo-adjuvant therapy) for LRH and ORH. Conclusion Our results are analogous to some of the previous retrospective studies showing comparable oncological outcomes of LRH to conventional open surgery. LRH confers the benefits of less blood loss, early recovery and shorter hospital stay. Further randomised trials with modifications in techniques are needed, and minimally invasive surgery should prosper. Keywords Laparoscopic Radical hysterectomy Minimally invasive Cancer cervix
Introduction
& Subbiah Shanmugam [email protected] 1
Department of Surgical Oncology, Government Royapettah Hospital, Cancer Block, Westcott Road, Royapettah, Chennai, Tamilnadu 600014, India
2
Department of Surgical Oncology, Government Kilpauk Medical College, Chennai 600010, India
Cancer of the cervix stands as fourth most common cancer among women worldwide, and the incidence is much higher in developing countries with lesser Human Development Index (HDI) [1]. In India, it is the second most common cancer and second common cause of cancer death among
Data Loading...
