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2005, Number 2

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Cir Cir 2005; 73 (2)

Laparoscopic hysterectomy in the surgical treatment of gynecological malignant and premalignant diseases

Maffuz-Aziz A, Cortés-Martínez G, Delgado-Ramírez R, Escudero-de los Ríos P, Quijano-Castro F, López-Hernández D

Language: Spanish
References: 39
Page: 107-112
PDF size: 58.95 Kb.


ABSTRACT

Introduction: laparoscopic hysterectomy (LH) is a safe surgical approach that offers patients a faster recovery. However, its use in malignant or premalignant gynecological lesions is not well established. The objective of the present study was to show the feasibility of LH in a tertiary cancer center.
Material and methods: we conducted a descriptive analysis of patients with histologically proven malignant or premalignant uterine lesions who underwent to LH. Surgical time, bleeding complications, and hospital stay were evaluated.
Results: twenty-five patients were included with a mean age of 45 years. Ten LH (40 %) with or without salpingo-oophorectomy for premalignant or preinvasive malignant lesions were done, five surgical staging procedures for endometrial cancer (20 %) and seven radical hysterectomies for cervical cancer (28 %). In three patients, conversion from laparotomy (12 %) was necessary for operative complications (two cases) or technical problems (one case). Mean operative time for the entire group was 207 min, mean bleeding 204 mL and mean hospital stay was 2.5 days. Postoperative complications were present in two patients, hematoma in the vaginal cupola (one case) and temporary bladder dysfunction (one case).
Conclusions: in the present trial we described our initial experience in LH for the treatment of malignant and premalignant gynecologic diseases. Our results suggest that it is a safe and feasible surgical approach. Long-term surveillance studies are necessary for the evaluation of recurrence patterns and overall survival.


REFERENCES

  1. Reich H, Decaprio J, McGlynn F. Laparoscopic histerectomy. J Gynecol Surg 1989;5:213-216.

  2. 2. Farquhar CM, Steiner CA. Hysterectomy rates in the Unites States 1990-1997. Obstet Gynecol 2002;99:229-234.

  3. 3. Hawe JA, Garry R. Laparoscopic hysterectomy. Semin Laparosc Surg 1999;6:80-89.

  4. 4. Magrina JF. Laparoscopic surgery for gynecologic cancers. Clin Obstet Gynecol 2000;43:619-640.

  5. 5. Ribeiro SC, Ribeiro RM, Santos NC, Pinotti JA. A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynaecol Obstet 2003;83:37-43.

  6. 6. Meinkle SF, Nugent EW, Orleans M. Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstet Gynecol 1997;89:304-311.

  7. 7. Litta P, Fracas M, Pozzan C, et al. Laparoscopic management of early stage endometrial cancer. Eur J Gynaecol Oncol 2003;24:41-44.

  8. 8. Lof FH, Koa RC. Laparoscopic hysterectomy versus abdominal hysterectomy: a controlled study of clinical and functional outcomes. Singapore Med J 2002;43:403-407.

  9. 9. Tsaltas J, Magnus A, Mamers PM, Lawrence AS, Lolatgis N, Healy DL. Laparoscopic and abdominal hysterectomy: a cost comparison. Med J Aust 1997;166:205-207.

  10. 10. Jones RA. Laparoscopic hysterectomy: a series of 100 cases. Med J Aust 1993;159:447-449.

  11. 11. Harkki-Siren P, Sjoberg J, Makinen J, et al. Finnish national register of laparoscopic hysterectomies: a review and complications of 1165 operations. Am J Obstet Gynecol 1997;176:118-122.

  12. 12. Manolitsas TP, McCartney AJ. Total laparoscopic hysterectomy in the management of endometrial carcinoma. J Am Assoc Gynecol Laparosc 2002;9:54-62.

  13. 13. Loh FH, Koa RC. Laparoscopic hysterectomy versus abdominal hysterectomy: a controlled study of clinical and functional outcomes. Singapore Med J 2002;43:403-407.

  14. 14. Summitt RL. Laparoscopic-assisted vaginal hysterectomy: a review of usefulness and outcomes. Clin Obstet Gynecol 2000;43:584-593.

  15. 15. Piver MS, Rutledge FN, Smith JP. Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol 1974;44:265.

  16. 16. Munro MG, Parker WH. A classification system for laparoscopic hysterectomy. Obstet Gynecol 1993;82:624-629.

  17. 17. Malur S, Possover M, Schneider A. Laparoscopically assisted radical vaginal versus radical abdominal hysterectomy type II in patients with cervical cancer. Surg Endosc 2001;15:289-292.

  18. 18. Hyun Nam J, Hyeok Kim J, Yeon Kim D, et al. Comparative study of laparoscopico-vaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer. Gynecol Oncol 2004;92:277-283.

  19. 19. Gayon-Vera E, Simon-Pereira LA. Histerectomía laparoscópica asistida vaginalmente contra histerectomía vaginal. Ginecol Obstet Mex 1999;67:164-168.

  20. 20. Park CT, Lim KT, Chung HW, et al. Clinical evaluation of laparoscopic-assisted radical vaginal hysterectomy with pelvic and/or paraaortic lymphadenectomy. J Am Assoc Gynecol Laparosc 2002;9:49-53.

  21. 21. Wattiez A, Soriano D, Cohen SB, et al. The learning curve of total laparoscopic hysterectomy: comparative analysis of 1647 cases. J Am Assoc Gynecol Laparosc 2002;9:339-345.

  22. 22. Wattiez A, Cohen SB, Selvaggi L. Laparoscopic hysterectomy. Curr Opin Obstet Gynecol 2002;14:417-422.

  23. 23. Holub Z, Jarbor A, Barto P, Hendl J, Urbánek T. Laparoscopic surgery in women with endometrial cancer: the learning curve. Eur J Obstet Gynecol Reprod Biol 2003;107:195-200.

  24. 24. Makinen J, Johansson J, Tomas C, et al. Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod 2001;16:1473-1478.

  25. 25. Magrina JF, Serrano L, Cornella JL. Laparoscopic lymphadenectomy and radical or modified radical vaginal hysterectomy for endometrial and cervical carcinoma—preliminary experience. J Gynecol Surg 1995;11:147–151.

  26. 26. Boike G, Lurain J, Burke J. A comparison of laparoscopic management of endometrial cancer with traditional laparotomy. Gynecol Oncol 1994;52:105.

  27. 27. Childers JM, Lang J, Surwit EA, Hatch KD. Laparoscopic surgical staging of ovarian cancer. Gynecol Oncol 1995;59:25–33.

  28. 28. Magrina JF, Mutone NF, Weaver AL, Magtibay PM, Fowler RS, Cornella JL. Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer: morbidity and survival. Am J Obstet Gynecol 1999;181:376–381.

  29. Liang Z, Xu H, Xiong G, et al. Clinical analysis of laparoscopic pelvic and paraaortic lymphadenectomy treated patients with gynecological malignancies. Zhonghua Fu Chan Ke Za Zhi 2002;37: 656-659 (abstract).

  30. 30. Spirtos NM, Eisenkop SM, Schlaerth JB, Ballon SC. Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy in patients with stage I cervical cancer: surgical morbidity and intermediate follow-up. Am J Obstet Gynecol 2002;187:340-348.

  31. 31. Summitt RL, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992;80:895-901.

  32. 32. Tsaltas J, Lawrence A, Michael M, Pearce S. Complications of laparoscopic hysterectomy: the Monash experience. Aust N Z J Obstet Gynaecol 2002;42:255-259.

  33. 33. Nezhat C, Nezhat F, Bess O, Nezhat CH. Injuries associated with the use of a linear stapler during operative laparoscopy: review of diagnosis, management, and prevention. J Gynecol Surg 1993;9:145-150.

  34. 34. Obermair A, Manolitsas TP, Leung Y, Hammond IG, McCartney AJ. Total laparoscopic hysterectomy for endometrial cancer: patterns or recurrence and survival. Gynecol Oncol 2004;92:789-793.

  35. 35. Magrina JF, Mutone NF, Weaver AL, Magtibay PM, Fowler RS, Cornella JL. Laparoscopic lymphadenectomy and vaginal or laparo-scopic hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer: morbidity and survival. Am J Obstet Gynecol 1999;181:376-381.

  36. 36. Pomel C, Atallah D, Le Bouedec G, et al. Laparoscopic radical hys-terectomy for invasive cervical cancer: 8-year experience of a pilot study. Gynecol Oncol 2003;91:534-539.

  37. 37. Barranger E, Cortez A, Grahek D, Callard P, Uzan S, Darai E. Laparoscopic sentinel node procedure for cervical cancer: impact of neoadjuvant chemoradiotherapy. Ann Surg Oncol 2004;11:445-452.

  38. 38. Martinez-Palones JM, Gil-Moreno A, Perez-Benavente MA, Roca I, Xercavins J. Intraoperative sentinel node identification in early stage cervical cancer using a combination of radiolabeled albumin injection and isosulfan blue dye injection. Gynecol Oncol 2004;92: 845-850.

  39. 39. Manko GF, Manko GF. Outpatient laparoscopic hysterectomy. Obstet Gynecol 2001;97:S21 (abstract).




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