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Laparoscopic versus open abdominal management of cervical cancer: long-term results from a propensity-matched analysis.

Abstract：

STUDY OBJECTIVE:To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN:Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING:University teaching hospital. PATIENTS:Sixty-five propensity-matched patient pairs (130 patients) undergoing either laparoscopy or open abdominal surgical procedures to treat cervical cancer. INTERVENTION:Radical hysterectomy plus lymphadenectomy was performed via the laparoscopic (LRH) or open abdominal approach (RAH). MEASUREMENT AND MAIN RESULTS:Baseline characteristics of the study populations were similar. In the LRH group the procedure was converted to open surgery in 2 patients (2%). Compared with the RAH group, patients undergoing LRH experienced less blood loss (200 vs 500 mL; p < .001), a lower transfusion rate (6% vs 22%; p = .02), similar operative time (245 vs 259.5 minutes; p = .26), and shorter length of hospital stay (4 vs 8 days; p < .001). No between-group differences in intraoperative complications were recorded (p = 1.0); however, a trend toward a lower postoperative complication rate (Accordion system grade ≥ 3) was observed for LRH compared with RAH (4 patients [6%]) vs 12 patients [18%]; p = .06). Five-year disease-free survival (p = .6, log-rank test) and overall survival (p = .31, log-rank test) did not differ statistically between women undergoing LRH or RAH. CONCLUSION:Laparoscopy ensures the same results as open surgery insofar as radicality and long-term survival. Use of the laparoscopic approach is associated with improved short-term results, minimizing the occurrence of severe postoperative complications.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Bogani G,Cromi A,Uccella S,Serati M,Casarin J,Pinelli C,Ghezzi F

doi

10.1016/j.jmig.2014.03.018

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

857-62

issue

5

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(14)00213-1

journal_volume

21

pub_type

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