Abstract:
STUDY OBJECTIVE:To investigate the factors associated with poorer oncologic outcomes in patients undergoing laparoscopic radical hysterectomy (LRH) for early stage cervical cancer. DESIGN:Multicenter retrospective study. SETTING:Three gynecologic oncology referral centers. PATIENTS:Patients with International Federation of Gynecology and Obstetrics 2009 stage IA (positive lymphovascular space invasion)-IB1 cervical cancer between January 2006 and June 2018. INTERVENTIONS:LRH (Piver type II-III hysterectomies). Lymph-node dissection was accomplished according to the tumor characteristics. MEASUREMENTS AND MAIN RESULTS:Surgical and oncologic outcomes were analyzed. Overall, 186 patients met the inclusion criteria, 16 (8.6%) experienced a recurrence, and 9 (4.8%) died of the disease (median follow-up period 37.9 months). Surgery-related complications did not influence disease-free survival. All the recurrences (16/16; 100%) occurred in patients with stage IB1 disease (p = .02), and 15 (93.7%) in cases involving tumors ≥2 cm. No association between positive lymph node and recurrence was detected (p =.82). Patients who had a preoperative diagnosis through conization (93; 50%) had a significantly lower rate of recurrence than those who underwent cervical biopsy (93; 50%): 1/93 (1.1%) vs 15/93 (16.1%); p <.001). The subanalysis of patients with International Federation of Gynecology and Obstetrics stage IB1 cervical cancer showed that patients undergoing preoperative conization (vs cervical biopsy) were less likely to experience a recurrence (odds ratio 0.09; 95% confidence interval 0.01-0.55). CONCLUSION:We confirmed that LRH was associated with a recurrence rate similar to that reported in the Laparoscopic Approach to Cervical Cancer trial. Tumor size ≥2 cm represents the most important risk factor influencing disease-free survival. However, we found that preoperative conization plays a potentially protective role in patients with an IB1 tumor.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Casarin J,Bogani G,Papadia A,Ditto A,Pinelli C,Garzon S,Donadello N,Laganà AS,Cromi A,Mueller M,Raspagliesi F,Ghezzi Fdoi
10.1016/j.jmig.2020.04.015subject
Has Abstractpub_date
2021-01-01 00:00:00pages
117-123issue
1eissn
1553-4650issn
1553-4669pii
S1553-4650(20)30190-4journal_volume
28pub_type
杂志文章abstract:STUDY OBJECTIVE:Because of the rapid growth of minimally invasive surgical procedures, we developed an ultrathin fiberscopic imaging system for laser surgery that could be an important instrument for clinical use in an office setting. METHODS AND MAIN RESULTS:A new device, consisting of a custom 1.1-mm diameter flexib...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.04.024
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:To identify risk factors associated with postoperative urinary retention in patients undergoing outpatient minimally invasive hysterectomy. DESIGN:A retrospective cohort study. SETTING:An academic medical center. PATIENTS:All patients undergoing outpatient minimally invasive hysterectomy between Janu...
journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
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abstract:STUDY OBJECTIVE:To demonstrate the feasibility of laparoscopic management of a huge myoma nascendi. DESIGN:Step-by-step video demonstration of the surgical procedure (Canadian Task Force classification III-C). SETTING:Uterine myoma is the most common benign neoplasm of the female reproductive tract, with an estimated...
journal_title:Journal of minimally invasive gynecology
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doi:10.1016/j.jmig.2016.09.003
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abstract:STUDY OBJECTIVE:To evaluate the feasibility of total laparoscopic hysterectomy (TLH) using the Hohl instrument in an initial cohort of patients. DESIGN:Retrospective cohort analysis (Canadian Task Force classification II-3). SETTING:Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.04.006
更新日期:2005-09-01 00:00:00
abstract::The rate of venous thromboembolic events (VTEs) including deep venous thrombosis and pulmonary embolism among women undergoing gynecologic surgery is high, particularly for women with a gynecologic malignancy. Current guidelines recommend VTE thrombopropylaxis in the immediate postoperative period for patients undergo...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.06.001
更新日期:2013-11-01 00:00:00
abstract::This article reveals our surgical approach for treatment of a patient with severe pelvic and infiltrative bladder endometriosis with mucosal involvement using robotic-assisted laparoscopic excision and cystotomy repair. To our knowledge, this is the first case of total robotic-assisted laparoscopic partial bladder res...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.07.002
更新日期:2008-11-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2009.01.007
更新日期:2009-05-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.02.017
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
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doi:10.1016/j.jmig.2019.07.013
更新日期:2020-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.08.003
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journal_title:Journal of minimally invasive gynecology
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doi:10.1016/j.jmig.2008.01.010
更新日期:2008-05-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.04.008
更新日期:2010-09-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.03.009
更新日期:2006-07-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.003
更新日期:2015-11-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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更新日期:2020-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2007-07-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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doi:10.1016/j.jmig.2018.01.004
更新日期:2018-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2015-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
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更新日期:2007-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2014-05-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2020-11-25 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
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更新日期:2020-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.02.012
更新日期:2013-05-01 00:00:00