Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):555-68. doi: 10.1016/j.jmig.2011.05.003. Epub 2011 Jul 23.
Laparoscopic radical hysterectomy is one surgical procedure currently performed to treat gynecologic cancer. The objective of this review was to update the current knowledge of laparoscopic radical hysterectomy in early invasive cervical cancer. Articles indexed in the MEDLINE database using the key words "Laparoscopic radical hysterectomy" and "Cancer of the cervix" were reviewed. Studies of laparoscopic radical hysterectomy for treatment of early cervical cancer with a minimum study population of 10 patients were selected. The laparoscopic approach was associated with less surgical morbidity (surgical bleeding) and with shorter length of hospital stay, although the duration of the operation may be longer. Laparoscopic radical hysterectomy with endoscopic pelvic lymphadenectomy, and paraaortic lymphadenectomy if needed, is a safe surgical option for treatment and staging of early invasive cervical cancer considering surgical risk, intraoperative bleeding, intraoperative and postoperative complications, and patient recovery. It is important to respect the learning curve. Surgical advances including new laparoscopic instrumentation and, in particular, use of robotics will contribute to reducing the duration of the operation and to facilitating learning and teaching of the procedure.
腹腔镜根治性子宫切除术是目前用于治疗妇科癌症的一种手术方法。本综述的目的是更新早期宫颈癌腹腔镜根治性子宫切除术的现有知识。使用“腹腔镜根治性子宫切除术”和“宫颈癌”这两个关键词在 MEDLINE 数据库中索引的文章进行了回顾。选择了至少有 10 名患者的腹腔镜根治性子宫切除术治疗早期宫颈癌的研究。腹腔镜方法与较低的手术发病率(手术出血)和较短的住院时间相关,尽管手术时间可能更长。对于早期浸润性宫颈癌的治疗和分期,考虑到手术风险、术中出血、术中及术后并发症以及患者康复,腹腔镜根治性子宫切除术联合内镜盆腔淋巴结切除术和必要时的腹主动脉旁淋巴结切除术是一种安全的手术选择。重要的是要尊重学习曲线。包括新的腹腔镜器械在内的手术进展,特别是机器人的使用,将有助于缩短手术时间,并促进该手术的学习和教学。