Τίτλος:
Laparoscopically Assisted Vaginal Radical Hysterectomy: Systematic
Review of the Literature
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Laparoscopically assisted vaginal radical vaginal hysterectomy (LAVRH),
a minimally invasive technique that seems to be an attractive
alternative to traditional surgery, remains unexplored in the treatment
of cervical cancer. We searched Medline (1966-2013) and Scopus
(2004-2013) search engines, as well as reference lists from all included
studies. Ten studies were retrieved; including 6 retrospective cohort
studies, 2 prospective cohort studies, 1 retrospective randomized trial,
and a phase II randomized control trial. LAVRH provided equal
recurrence-free rates when performed in patients with tumors not
exceeding 2 cm in greatest diameter. Its main advantages seem to be less
intraoperative blood loss and more radical pelvic lymphadenectomy. The
primary disadvantages, of the technique are a higher rate of
disease-positive surgical margins, resulting in the need for adjuvant
therapy, and the slow learning curve required for a surgeon to gain
expertise. With use in minimally invasive surgery of newer techniques
such as total laparoscopic radical hysterectomy and robotic-assisted
radical hysterectomy, and possible future adoption of more conservative
techniques such as cervical conization with pelvic lymphadenectomy, the
question remains as to whether LAVRH will be adopted by the surgical
community or lost to oblivion. (C) 2013 AAGL. All rights reserved.
Συγγραφείς:
Pergialiotis, Vassileios
Rodolakis, Alexandros
Christakis,
Dimitrios
Thomakos, Nikolaos
Vlachos, Georgios
Antsaklis,
Aristides
Περιοδικό:
Journal of Minimally Invasive Gynecology
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Λέξεις-κλειδιά:
Coelio-Schauta; LAVRH; Radical hysterectomy; Vaginal; Wertheim
DOI:
10.1016/j.jmig.2013.04.021