Surgicopdthologic outcome of laparoscopic versus open radical hysterectomy

Objective. To compare the surgicopathologic outcome of total laparoscopic radical hysterectorny (LRH) with that of abdominal radical hysterectomy (ARH) for the treatment of early-stage cervical cancer. Methods. Radical hysterectomy specimens of sequential patients undergoing LF-H (N 50) were compared with those of historical controls selected from consecutive women who have had conventional ARIi (N=48), arid who met thesame criteria for eligibility as the cases. To evaluate the extent of pararrietrial resection, parametrial tissues were systematically measured at their widest dimensions before tissue processing. Results. No difference was found in demographics, histologic type, tumor stage and grade between the two groups. The parametrial width was similar between LRH and ARH in both type IT (right parametrium: 2.4 cm (1 -3) vs. 2.3 (1.8-4.0), p=0.28; left parametrium: 2.3 cm (1.8-4) vs. 2.2 (1.2-3.0), p=0.54) and type III radical hysterectomy (right parametrium: 3.8 cm (2.3-6.5) vs. 3.4 (1.7-7.0), p=0.59; left parametrium: 3.6 cm (2-6) vs. 3.5 (1.5-6.5), p=0.82). There were no significant differences between the two groups with regard to lyrnph nodes yield and likelihood of identifying positive margins or metastatic disease. Conclusion. Our results suggest that laparoscopically managed patients with cervical cancer undergo a similar extent of surgery as those treated with the traditional ARH, as judged by objective pathologic criteria. (c) 2007 Elsevier Inc. All rights reserved.