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A Comparison of Radical Vaginal Hysterectomy Combined With Extraperitoneal or Laparoscopic Pelvic Lymphadenectomy in the Treatment of Cervical Cancer
  1. Diego Maestri, MSc*,
  2. Rosilene Jara Reis, PhD,,§,
  3. Omar Moreira Bacha, MSc,
  4. Betânia Müller, MD and
  5. Oly Campos Corleta, PhD,#
  1. *School of Medicine, Universidade do Oeste de Santa Catarina, Joaçaba, SC, and Hospital São Miguel, Joaçaba;
  2. Medical Residency Program, Presidente Vargas Hospital,
  3. Santa Rita Hospital, and
  4. §Ernesto Dorneles Hospital, Porto Alegre, RS, Brazil;
  5. CHUQ, Hôtel Dieu of Québec, Quebec, Canada;
  6. General Surgery Residency Program at Hospital de Clínicas de Porto Alegre; and
  7. #Post Graduate Program in Medicine–Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
  1. Address correspondence and reprint requests to Diego Maestri, MSc, Av. Santa Terezinha, 243/401–Centro, Joaçaba, SC, Brazil, 89.600-000. E-mail: dimaestri{at}terra.com.br.

Abstract

Background 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.

Methods Twenty-five patients with cervical carcinoma (stages IA1 to IIA) were submitted to radical vaginal hysterectomy and extraperitoneal or laparoscopic lymphadenectomy.

Results 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).

Conclusions 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.

  • Schauta surgery
  • Video-laparoscopic lymphadenectomy
  • Mitra technique
  • Cervical carcinoma

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