Laparoscopic radical hysterectomy and pelvic lymph node dissection for early cervical cancer effectively improves surgical efficacy.

OBJECTIVE

To evaluate the efficacy and safety of laparoscopic radical hysterectomy (LRH) combined with pelvic lymph node dissection (PLND) in patients with early-stage cervical cancer.

METHODS

This retrospective study analyzed 58 cases of early cervical cancer who underwent surgical treatment at Western Theater Command General Hospital between January 2019 and September 2020. Patients were divided into two groups based on surgical approach: the observation group (n=26) received LRH and PLND without uterine manipulator, while the control group (n=32) underwent LRH with uterine manipulator and PLND. Clinical data including operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of lymph nodes dissected, and postoperative pain (VAS score at 7 days) were compared between groups. Serum tumor markers (CA125, CA199, CEA, and SCC) were measured and analyzed. Postoperative complications and quality of life were assessed during a 6-month follow-up period. Patients were further categorized into good prognosis (n=40, no recurrence) and poor prognosis (n=18, recurrence) groups based on 1-year follow-up outcomes to identify independent prognostic factors.

RESULTS

The observation group demonstrated significantly better outcomes compared to the control group, including shorter operative time, reduced intraoperative blood loss, earlier return of bowel function, shorter hospital stay, lower postoperative pain scores, and decreased serum tumor marker levels (all P<0.05). The observation group also had a higher number of lymph nodes dissected (P<0.05). Furthermore, this group showed a significantly lower incidence of postoperative complications and better quality of life at 6 months postoperatively (P<0.05). Multivariate analysis identified the number of lymph nodes dissected and surgical approach as independent prognostic factors.

CONCLUSION

LRH without uterine manipulator combined with PLND demonstrates superior surgical outcomes, reduced complication rates, and improved recovery for patients with early-stage cervical cancer, representing a valuable advancement in clinical practice.