Objective: To investigate the possibility and value of laparoscopic radial hysterectomy with lymphadenectomy in patients with gynecology malignancies.
Methods: From July 2000 through June 2002, we performed laparoscopic radial hysterectomy with lymphadenectomy on 56 patients with biopsy-proven endometrial or cervical carcinoma (21 endometrial cancer and 35 cervical cancers). Pelvic, para-aortic, and combinations of both pelvic and para-aortic lymphadenectomies were performed depending on the primary site of the disease and indication for lymph node dissection.
Results: Laparoscopic procedure required an average of 3.1 h, with an average blood loss of 198 ml. The average number of nodes was 16. Patients undergoing laparoscopic assisted vaginal radical hysterectomy and lymphadenectomy alone were admitted for 9.6 days on average. There were 5 patients with intraoperative complications. Two patients were bladder injury and other two patients with venous injury. One patient was colon injury and converted to an abdominal procedure. There were no ureteral or intestinal injuries. Postoperative complications occurred in 3% of patients and only one was considered ureteral constriction 1 month after operation. There has been one patient with trocar site recurrences 4 weeks after operation. Three patients have retention of urine.
Conclusions: Laparoscopic assisted vaginal radical hysterectomy and lymphadenectomy was feasible and safe for treatment of cervical or endometrial cancer. Also it was a less invasive, and recovery time was reduced. This was reliable and accurate method for evaluating lymph node metastasis of cervical or endometrial carcinoma.