Comparing thermal welding instrument-assisted laparoscopic radical hysterectomy versus conventional radical hysterectomy in the management of FIGO IB1 squamous cell cervical carcinoma

摘要

Purpose of investigation: The authors sought to evaluate the feasibility and acceptability of using the thermal welding technique with thermal ligating shear (TWT-TLS)-assisted laparoscopic radical hysterectomy (LRH) and systemic pelvic lymphadenectomy (SPL) in the management of Stage IB1 squamous cell carcinoma of the cervix. Materials and Methods: The authors compared operating time, blood loss, and other intra- and postoperative parameters and outcomes in 53 patients between May 2003 and April 2007. Results: Twenty-three patients were treated with TWT-TLS-assisted LRH and SPL (TWT-TLS group) and 30 patients with abdominal radical hysterectomy (ARH) and SPL (ARH group). The surgical time of the TWT-TLS group was significantly shorter than that of the ARH group (221.4 vs 264.6 min, p < 0.05). The blood loss of the TWT-TLS group was less than that of the ARH group (195.7 vs 1,214.7 ml, p < 0.001). The immediate postoperative recovery seemed to be rapid in the TWT-TLS group compared with the ARH group (1.4 vs 3.5 days for full diet, p < 0.001; 8.32 vs 12.14 days for hospital stay, p < 0.001). The recurrence rate between the two groups was similar during the median four-year follow-up (8.7% vs 13.3%). Conclusions: TWT-TLS is a safe and efficient method for laparoscopic RH and SPL with reduction of morbidity for early-stage cervical cancer. A further study is needed to confirm the above observation.