Laparoscopic lymphadenectomy and laparoscopic-assisted vaginal hysterectomy
2003; Elsevier BV; Volume: 90; Issue: 3 Linguagem: Inglês
10.1016/s0090-8258(03)00497-9
ISSN1095-6859
Autores Tópico(s)Uterine Myomas and Treatments
ResumoThe role of laparoscopy in the management of cervical cancer has been evolving over the past 15 years. Dargent [ [1] Dargent D. A new future for Schauta's operation through a presurgical retroperitoneal pelviscopy. Eur J Gynaecol Oncol. 1987; 8: 292-296 Google Scholar ] first suggested that laparoscopic pelvic lymphadenopathy could be followed by a Schauta radical hysterectomy and published the results of such a procedure in 1987. His 3-year survival rate in 51 patients with negative pelvic nodes was 95.5%. Querleu [ [2] Querleu D. Case report laparoscopically assisted radical vaginal hysterectomy. Gynecol Oncol. 1993; 51: 248-254 Abstract Full Text PDF PubMed Scopus (126) Google Scholar ] reported 8 patients in 1993, and demonstrated less blood loss, shorter hospital stay, and decreased pain, as compared to an abdominal operation. Hatch [ [3] Hatch K.D. Hallum III, A.V. Nour M. New surgical approaches to treatment of cervical cancer. J Natl Cancer Inst Monogr. 1996; 21: 71-75 PubMed Google Scholar ] in 1996, reported 37 patients treated by laparoscopic, pelvic, and periortic lymphadenectomy followed by radical vaginal hysterectomy. The mean blood loss was 525 mL and the average hospital stay was 3 days. Blood transfusions were required in 11% of the patients compared to 35–95% reported for radical abdominal hysterectomy. Roy [ [4] Roy M. Plante M. Renaud M.C. Tetu B. Vaginal radical hysterectomy versus abdominal radical hysterectomy in the treatment of early-stage cervical cancer. Gynecol Oncol. 1996; 62: 336-339 Abstract Full Text PDF PubMed Scopus (83) Google Scholar ] reported 52 patients in whom laparoscopic pelvic lymphadenectomy was followed by radical vaginal hysterectomy in 25 cases or a radical abdominal hysterectomy in 27 cases. The two groups were comparable in blood loss, operative time and blood transfusion.
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