Incorporating 3D laparoscopy for the management of locally advanced cervical cancer: A comparison with open surgery

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Abstract

Purpose: To test the effects of the implementation of 3D laparoscopic technology for the execution of nervesparing radical hysterectomy. Methods: Thirty patients undergoing nerve-sparing radical hysterectomy via 3D laparoscopic (3D-LNSRH, n = 10) or open surgery (NSRH, n = 20) were studied prospectively. Results: No significant differences were observed in baseline patient characteristics. Operative times were similar between groups. We compared the first 10 patients undergoing 3D-LNSRH with the last 20 patients undergoing NSRH. Baseline characteristics were similar between groups (p>0.2). Patients undergoing 3D-LNSRH had longer operative time (264.4 ± 21.5 vs 217.2 ± 41.0 minutes; p = 0.005), lower blood loss (53.4 ± 26.1 vs 177.7 ± 96.0 mL; p<0.001), and shorter length of hospital stay (4.3 ± 1.2 vs 5.4 ± 0.7 days; p = 0.03) in comparison to patients undergoing open abdominal procedures. No intraoperative complication occurred. One (10%) patient had conversion to open surgery due to technical difficulties and the inability to insert the uterine manipulator. A trend towards higher complication (grade 2 or worse) rate was observed for patients undergoing NSRH in comparison to 3D-LNSRH (p = 0.06). Considering only severe complications (grade 3 or worse), no difference was observed (0/10 vs 2/20; p = 0.54). Conclusions: 3D-laparoscopic nerve-sparing radical hysterectomy is a safe and effective procedure. The implementation of 3D laparoscopic technology allows the execution of challenging operations via minimally invasive surgery, thus reducing open abdominal procedure rates. Further large prospective studies are warranted.

Original languageEnglish
Pages (from-to)393-397
Number of pages5
JournalTumori
Volume102
Issue number4
DOIs
Publication statusPublished - Jul 1 2016

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Uterine Cervical Neoplasms
Laparoscopy
Hysterectomy
Operative Time
Length of Stay
Conversion to Open Surgery
Technology
Minimally Invasive Surgical Procedures
Intraoperative Complications
Prospective Studies

Keywords

  • 3D
  • Laparoscopy
  • Locally advanced cervical cancer
  • Radical hysterectomy

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

@article{7547ac5f084f46e5a086a5dbf561eae6,
title = "Incorporating 3D laparoscopy for the management of locally advanced cervical cancer: A comparison with open surgery",
abstract = "Purpose: To test the effects of the implementation of 3D laparoscopic technology for the execution of nervesparing radical hysterectomy. Methods: Thirty patients undergoing nerve-sparing radical hysterectomy via 3D laparoscopic (3D-LNSRH, n = 10) or open surgery (NSRH, n = 20) were studied prospectively. Results: No significant differences were observed in baseline patient characteristics. Operative times were similar between groups. We compared the first 10 patients undergoing 3D-LNSRH with the last 20 patients undergoing NSRH. Baseline characteristics were similar between groups (p>0.2). Patients undergoing 3D-LNSRH had longer operative time (264.4 ± 21.5 vs 217.2 ± 41.0 minutes; p = 0.005), lower blood loss (53.4 ± 26.1 vs 177.7 ± 96.0 mL; p<0.001), and shorter length of hospital stay (4.3 ± 1.2 vs 5.4 ± 0.7 days; p = 0.03) in comparison to patients undergoing open abdominal procedures. No intraoperative complication occurred. One (10{\%}) patient had conversion to open surgery due to technical difficulties and the inability to insert the uterine manipulator. A trend towards higher complication (grade 2 or worse) rate was observed for patients undergoing NSRH in comparison to 3D-LNSRH (p = 0.06). Considering only severe complications (grade 3 or worse), no difference was observed (0/10 vs 2/20; p = 0.54). Conclusions: 3D-laparoscopic nerve-sparing radical hysterectomy is a safe and effective procedure. The implementation of 3D laparoscopic technology allows the execution of challenging operations via minimally invasive surgery, thus reducing open abdominal procedure rates. Further large prospective studies are warranted.",
keywords = "3D, Laparoscopy, Locally advanced cervical cancer, Radical hysterectomy",
author = "Francesco Raspagliesi and Giorgio Bogani and Fabio Martinelli and Mauro Signorelli and Valentina Chiappa and Cono Scaffa and Ilaria Sabatucci and Marco Adorni and Domenica Lorusso and Antonino Ditto",
year = "2016",
month = "7",
day = "1",
doi = "10.5301/tj.5000527",
language = "English",
volume = "102",
pages = "393--397",
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TY - JOUR

T1 - Incorporating 3D laparoscopy for the management of locally advanced cervical cancer

T2 - A comparison with open surgery

AU - Raspagliesi, Francesco

AU - Bogani, Giorgio

AU - Martinelli, Fabio

AU - Signorelli, Mauro

AU - Chiappa, Valentina

AU - Scaffa, Cono

AU - Sabatucci, Ilaria

AU - Adorni, Marco

AU - Lorusso, Domenica

AU - Ditto, Antonino

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Purpose: To test the effects of the implementation of 3D laparoscopic technology for the execution of nervesparing radical hysterectomy. Methods: Thirty patients undergoing nerve-sparing radical hysterectomy via 3D laparoscopic (3D-LNSRH, n = 10) or open surgery (NSRH, n = 20) were studied prospectively. Results: No significant differences were observed in baseline patient characteristics. Operative times were similar between groups. We compared the first 10 patients undergoing 3D-LNSRH with the last 20 patients undergoing NSRH. Baseline characteristics were similar between groups (p>0.2). Patients undergoing 3D-LNSRH had longer operative time (264.4 ± 21.5 vs 217.2 ± 41.0 minutes; p = 0.005), lower blood loss (53.4 ± 26.1 vs 177.7 ± 96.0 mL; p<0.001), and shorter length of hospital stay (4.3 ± 1.2 vs 5.4 ± 0.7 days; p = 0.03) in comparison to patients undergoing open abdominal procedures. No intraoperative complication occurred. One (10%) patient had conversion to open surgery due to technical difficulties and the inability to insert the uterine manipulator. A trend towards higher complication (grade 2 or worse) rate was observed for patients undergoing NSRH in comparison to 3D-LNSRH (p = 0.06). Considering only severe complications (grade 3 or worse), no difference was observed (0/10 vs 2/20; p = 0.54). Conclusions: 3D-laparoscopic nerve-sparing radical hysterectomy is a safe and effective procedure. The implementation of 3D laparoscopic technology allows the execution of challenging operations via minimally invasive surgery, thus reducing open abdominal procedure rates. Further large prospective studies are warranted.

AB - Purpose: To test the effects of the implementation of 3D laparoscopic technology for the execution of nervesparing radical hysterectomy. Methods: Thirty patients undergoing nerve-sparing radical hysterectomy via 3D laparoscopic (3D-LNSRH, n = 10) or open surgery (NSRH, n = 20) were studied prospectively. Results: No significant differences were observed in baseline patient characteristics. Operative times were similar between groups. We compared the first 10 patients undergoing 3D-LNSRH with the last 20 patients undergoing NSRH. Baseline characteristics were similar between groups (p>0.2). Patients undergoing 3D-LNSRH had longer operative time (264.4 ± 21.5 vs 217.2 ± 41.0 minutes; p = 0.005), lower blood loss (53.4 ± 26.1 vs 177.7 ± 96.0 mL; p<0.001), and shorter length of hospital stay (4.3 ± 1.2 vs 5.4 ± 0.7 days; p = 0.03) in comparison to patients undergoing open abdominal procedures. No intraoperative complication occurred. One (10%) patient had conversion to open surgery due to technical difficulties and the inability to insert the uterine manipulator. A trend towards higher complication (grade 2 or worse) rate was observed for patients undergoing NSRH in comparison to 3D-LNSRH (p = 0.06). Considering only severe complications (grade 3 or worse), no difference was observed (0/10 vs 2/20; p = 0.54). Conclusions: 3D-laparoscopic nerve-sparing radical hysterectomy is a safe and effective procedure. The implementation of 3D laparoscopic technology allows the execution of challenging operations via minimally invasive surgery, thus reducing open abdominal procedure rates. Further large prospective studies are warranted.

KW - 3D

KW - Laparoscopy

KW - Locally advanced cervical cancer

KW - Radical hysterectomy

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