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2022-RA-1430-ESGO Minimally invasive surgery in early stage cervical cancer
  1. Diana Elena Soare,
  2. Andrei Manu and
  3. Elvira Bratila
  1. Obstetrics and Gynecology, Clinical Hospital of Obstetrics and Gynecology ‘Prof. Dr. Panait Sirbu’, Bucharest, Romania


Introduction/Background The standard treatment for early stage cervical cancer is represented by radical histerectomy with pelvic lymphadenectomy. Laparotomy has been the main choice of approach for a long period of time and, although effective, it is highly invasive and associated with increased morbidity, longer hospital stay and postoperative complications. Since the early 1990’s radical histerectomy with pelvic lymphadenectomy has been succesfully performed laparoscopically. The use of minimally invasive techniques has led to better postoperative outcomes, lower intraoperative bloos loss and shorter hospital stay. Although there is recent debate concerning the significant inferiority of the minimally invasive approach followed by the LACC study in 2018, there are recent studies that question its findings and that sustain that there is still an important place for minimally invasive surgery (MIS) in early cervical cancer.

Methodology We present a systematic review in which we included articles concerning minimally invasive surgery in cervical cancer and the future perspective of this approach.

Results There are several meta-analysis that compared minimally invasive surgery with open surgery for early cervical cancer. Concerning intraoperative blood loss, hospital stay and posoperative complications there are four meta-analysis that conclude that laparoscopic approach is superior to the abdominal one. Careful selection of patients can lead to excelent oncologic outcomes. The results from the studies incriminating minimally invasive surgery showed no significant differences in disease free survival rate and overall survival rate for low risk cervical cancer. So, at least for these patients, MIS is naturally a better solution. Fertility sparing surgery includes mainly patients with low risk cervical cancer,a category for which MIS should be primarily used for.

Conclusion While there are still aspects that undoubtly need to be improved concerning a standardized technique, minimally invasive surgery still has an important role in the treatment of early stage cervical cancer.

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