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Laparotomy Conversion Rate of Laparoscopic Radical Hysterectomy for Early-stage Cervical Cancer in a Consecutive Series without Case Selection

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To estimate the feasibility and conversion rate of laparoscopic radical hysterectomy (LRH) in early-stage cervical cancer.

Methods

Data were collected from the medical records of 260 consecutive patients with stage IA2 to IIA2 cervical cancer who had undergone LRH, regardless of age, body mass index, prior abdominal surgery, uterus size, or tumor size.

Results

The median patient age was 48 years (range, 26–78 years), 11.9 % of whom were elderly (≥65 years), 11.2 % were obese (≥30 kg/m2), 15.4 % had undergone previous abdominal surgery, and 13.1 % had a tumor larger than 4 cm. Negative-margin resection was feasible in all patients except one. The median operative time and estimated blood loss were 253 min (range, 111–438 min) and 300 mL (range, 80–2000 mL), respectively. Intraoperative and postoperative complications occurred in seven (2.7 %) and 10 patients (3.8 %), respectively. Four patients (1.5 %) required intraoperative conversion to laparotomy, three of which were due to conglomerated metastatic lymph nodes surrounding the aorta (n = 2), the left external iliac vein (n = 1) or the left ureter (n = 1). LRH was still completed in the four conversion patients, and a laparotomy was required for the removal of the conglomerated metastatic lymph nodes and the repair of the injured vessels.

Conclusions

The conversion rate to laparotomy among patients undergoing LRH for early-stage cervical cancer was 1.5 % when performed exclusively in consecutive patients. LRH showed comparable feasibility and effectiveness to open radical hysterectomy in the treatment of early-stage cervical cancer.

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Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong-Yeol Park MD, PhD & Joo-Hyun Nam MD, PhD

Authors
  1. Jeong-Yeol Park MD, PhD
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  2. Joo-Hyun Nam MD, PhD
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Correspondence to Joo-Hyun Nam MD, PhD.

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Park, JY., Nam, JH. Laparotomy Conversion Rate of Laparoscopic Radical Hysterectomy for Early-stage Cervical Cancer in a Consecutive Series without Case Selection. Ann Surg Oncol 21, 3030–3035 (2014). https://doi.org/10.1245/s10434-014-3707-5

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  • DOI: https://doi.org/10.1245/s10434-014-3707-5

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