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Benefit of robot-assisted laparoscopy in nerve-sparing radical hysterectomy: urinary morbidity in early cervical cancer

Abstract

Objective

To evaluate the feasibility of nerve-sparing radical hysterectomy in early cervical cancer by robot-assisted laparoscopy and atonic bladder rate.

Methods

This was a retrospective study with consecutive patients in three gynecological oncology departments. Patients with <2 cm cervical cancer had nerve-sparing radical hysterectomy by robot-assisted laparoscopy and pelvic lymphadenectomy. Two days after surgery, we systematically removed the Foley bladder catheter.

Results

The median (range) age and body mass index of the 30 patients were 44 (33–68) years and 23.9 (17.7–39.4) kg/m2, respectively. The median (range) tumor diameter at the time of surgery was 13 (4–38) mm. The median (range) operative time, blood loss, and number of pelvic lymph nodes (any common iliac lymph nodes) were 305 (180–405) min, 100 (30–1,500) ml, and 18 (7–28). The overall complication rate was 52.3 %, of which 6.7 % atonic bladder. Twenty-eight patients (93.3 %) were discharged 2 days after surgery with spontaneous voiding and no residual urine >100 ml.

Conclusions

Nerve-sparing radical hysterectomy by robot-assisted laparoscopy is feasible in early cervical cancer (<2 cm). A total of 93.3 % of the patients were discharged 2 days after surgery with spontaneous voiding. The next step would be a prospective study with objective urodynamic investigations.

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Acknowledgments

We thank the patients who participated; and we thank Arnaud Payen. We also thank GCS “Centre de Référence Régional en Cancérologie,” Francoise Weingertner, and Cathy De Mendonca; and Direction Générale, Lille, France.

Disclosures

Drs. Narducci, Collinet, Merlot, Lambaudie, Boulanger, Lefebvre-Kuntz, Nickers, Taieb, Houvenaeghel, and Leblanc have no conflicts of interest or financial ties to disclose.

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Correspondence to Benjamin Merlot.

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Narducci, F., Collinet, P., Merlot, B. et al. Benefit of robot-assisted laparoscopy in nerve-sparing radical hysterectomy: urinary morbidity in early cervical cancer. Surg Endosc 27, 1237–1242 (2013). https://doi.org/10.1007/s00464-012-2582-z

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Keywords

  • Atonic bladder
  • Cervical carcinoma
  • Radical hysterectomy
  • Robot-assisted laparoscopy
  • Urinary tract dysfunction