Histerectomía radical laparoscópica total en el cáncer de cérvix. Factibilidad,morbilidad y supervivencia |
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Authors: | Ángel Martín Jiménez Anna Torrent Colomer Isabel Bover Barceló Rodolfo Moreno Mira Ricardo Lizarbe Iranzo Javier Barrés Echevarri |
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Institution: | 1. Unidad de Ginecología. Hospital Son Llàtzer. Palma de Mallorca. Islas Baleares. España;2. Unidad e Oncología. Hospital Son Llàtzer. Palma de Mallorca. Islas Baleares. España |
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Abstract: | ObjectiveTo assess feasibility, perioperative morbidity and medium term survival of total laparoscopic radical hysterectomy in cervical cancer.Material and methodsA total of 31 consecutive patients diagnosed FIGO clinical stage IA2 (n = 4), IB1 (n = 22), IIA (n = 2) and IB2 (n = 3) in Son Llàtzer hospital (Palma de Mallorca) that were programmed for a total laparoscopic radical hysterectomy were studied. We analyzed tumor histological characteristics, surgical technique, perioperative variables, postoperative complications and mid-term survival results.ResultsFeasibility rate was 96%. The most frequently operative complication was accidental bladder incision (3 cases). Postoperative complications rate was 20% (6 cases) which includes one surgical reintervention. Average operative time was 258 minutes (range: 180-360). Blood transfusion rate was 17% (n = 5) and mean hospital stay was 7.8 days (range: 2-29). After one month after surgery 72% of patients had a normal miccional function. Mean tumoral size was 26.5 mm and lymphatic positive nodes rate was 17% (n = 5). Mean follow-up time was 26 months. Tumor relapse rate was 17% (n = 5) and survival-free disease of 100% for IA2 stage, 82.6% of IB1/IIA stages and 66.7% for IB2 stage.ConclusionsTotal laparoscopic radical hysterectomy is a feasible technique in most of the patients with cervical cancer. It needs more operative time than abdominal route but it presents less perioperative morbidity, less blood transfusion and less ospitalization days. The medium term survival is comparable with conventional abdominal route. |
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Keywords: | Cá ncer de cé rvix Cá ncer de ú tero Histerectomí a radical Cirugí a Laparoscopia Supervivencia Morbilidad Preservació n nerviosa |
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