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Laparoscopic Nerve-Sparing Radical Parametrectomy for Occult Early-Stage Invasive Cervical Cancer After Simple Hysterectomy
  1. Junnan Li, MD,
  2. Huicheng Xu, MD,
  3. Yong Chen, MD,
  4. Dan Wang, MD,
  5. Yuyan Li, MD and
  6. Zhiqing Liang, PhD, MD
  1. From the Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, PR China.
  1. Address correspondence and reprint requests to Zhiqing Liang, PhD, MD, Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. E-mail: zhi.lzliang{at}gmail.com.

Abstract

Objective To investigate the feasibility and surgical outcomes of laparoscopic nerve-sparing radical parametrectomy (LNSRP) and lymphadenectomy for treatment of occult early-stage invasive cervical cancer after simple hysterectomy.

Methods From 2006 to 2010, 28 patients who were discovered to have occult early-stage invasive cervical cancer after a simple hysterectomy underwent LNSRP, upper vaginal resection, and pelvic lymphadenectomy. A retrospective analysis of these cases was performed.

Results All patients underwent successful LNSRP. There was no conversion to laparotomy. The mean ± SD operation time was 173.30 ± 56.20 minutes. The mean ± SD estimated blood loss was 230.00 ± 109.55 mL. Two intraoperative complications were recorded. The median number of extracted pelvic and para-aortic lymph nodes was 23 (range, 12–36) and 7 (range, 3–15), respectively. The mean ± SD time before Foley catheter removal was 5.6 ± 2.74 days (range, 3–14 days ), and bladder voiding function recovery to grade 0 to grade 1 was observed in 26 patients (92.9%). Of the 28 patients, 3 patients received further adjuvant therapy. The median follow-up period was 38 (range, 4–62) months for all patients. No recurrence case was found in this series.

Conclusion Laparoscopic nerve-sparing radical parametrectomy is a therapeutic option for occult early-stage invasive cervical cancer discovered after hysterectomy. Nerve-sparing radical surgery in indicated patients may lead to optimal preservation of bladder function.

  • Occult cervical cancer
  • Laparoscopy
  • Nerve sparing
  • Radical parametrectomy

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Footnotes

  • The authors declare no conflict of interest.

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