Minimally invasive surgery for early-stage cervical cancer: is the uterine manipulator a risk factor?

2019 ◽  
Vol 221 (5) ◽  
pp. 537-538 ◽  
Author(s):  
Anna Dietl ◽  
Maximilian Klar ◽  
Konrad Aumann
Keyword(s):  
Cervical Cancer ◽  
Risk Factor ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Uterine Manipulator ◽  
Early Stage Cervical Cancer

scholarly journals The Surgeon’s Proficiency Affected Survival Outcomes of Minimally Invasive Surgery for Early-Stage Cervical Cancer: A Retrospective Study of 851 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Ying Yang ◽  
Yue Huang ◽  
Zhengyu Li
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Early Stage ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Surgery Group ◽  
Early Stage Cervical Cancer

PurposeTo compare the clinical outcomes of patients with early-stage cervical cancer who underwent minimally invasive surgery (MIS) by surgeons in different phases and evaluate whether the proficiency of surgeons affects the survival outcomes.Materials and MethodsA total of 851 patients with early-stage cervical cancer who underwent radical hysterectomy between January 2008 and June 2018 (every year from January to June) at a tertiary hospital were retrospectively analyzed. We categorized patients into four phases according to their sequence (phase one, 1-10 cases; phase two: 11-20 cases; phase three: 21-30 cases; phase four: > 30 cases). Demographics and clinical and pathological data were collected and analyzed.ResultsThere were no statistical differences between the open surgery and MIS groups regarding three- and five-year overall survival (OS) and disease-free survival (DFS). The OS and DFS of patients in the MIS group in phase one were significantly lower than those in later phases and those in the open surgery group after adjustment (OS, P = 0.009; HR, 2.896; 95%CI, 1.303-6.435; DFS, P = 0.009; HR, 2.712; 95%CI, 1.289-5.706). Survival outcomes were not statistically significant when comparing different surgeons.ConclusionThe phase one cases of MIS had lower OS and DFS than those in later phases and those in the open surgery group. Thus, we suggest that the proficiency of surgeons is associated with survival outcomes of MIS. Favorable outcomes can be obtained after a certain number of MIS cases.

scholarly journals Trachelectomy for reproductive-aged women with early-stage cervical cancer: minimally invasive surgery versus laparotomy

2019 ◽  
Vol 220 (5) ◽  
pp. 469.e1-469.e13 ◽  
Author(s):  
Koji Matsuo ◽  
Ling Chen ◽  
Rachel S. Mandelbaum ◽  
Alexander Melamed ◽  
Lynda D. Roman ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Early Stage Cervical Cancer ◽  
Reproductive Aged Women

scholarly journals Robotic radical hysterectomy for early-stage cervical cancer: A systematic literature review

2021 ◽  
Vol 2 (2) ◽  
pp. 33-42
Author(s):  
Gun Oh Chong
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Radical Hysterectomy ◽  
Open Surgery ◽  
Early Stage ◽  
Laparoscopic Approach ◽  
Robotic Radical Hysterectomy ◽  
Early Stage Cervical Cancer

Robotic technology has recently come into widespread use to overcome the limitations of laparoscopic radical hysterectomy in the treatment of early-stage cervical cancer. Most comparative studies showed that blood loss and hospital stays for patients undergoing minimally invasive surgery, including robotic procedures, were superior compared to open surgery. Moreover, the survival outcomes of robotic radical hysterectomy were not inferior to open radical hysterectomy. Unexpectedly, the Laparoscopic Approach to Cervical Cancer (LACC) trial, a randomized, open-label, noninferiority study that compared minimally invasive radical hysterectomy with open radical hysterectomy, revealed that minimally invasive surgery was associated with a higher risk of recurrence and death compared with open surgery. Strict guidelines for robotic radical hysterectomy for the treatment of early-stage cervical cancer should be established in accordance with objective Korean data. In addition, it is recommended that further studies should be performed on how to avoid the use of uterine manipulators and the dissemination of cancer cells by ensuring a more effective vaginal closure using a standardized approach.

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