Laparoscopic Nerve-Sparing Radical Parametrectomy For Occult Early-Stage Invasive Cervical Cancer After Simple Hysterectomy

Objective: To investigate the feasibility and surgical outcomes of laparoscopic nerve-sparing radical parametrectomy (LNSRP) and lymphadenectomy for treatment of occult early-stage invasive cervical cancer after simple hysterectomy.Methods: From 2006 to 2010, 28 patients who were discovered to have occult early-stage invasive cervical cancer after a simple hysterectomy underwent LNSRP, upper vaginal resection, and pelvic lymphadenectomy. A retrospective analysis of these cases was performed.Results: All patients underwent successful LNSRP. There was no conversion to laparotomy. The mean +/- SD operation time was 173.30 +/- 56.20 minutes. The mean +/- SD estimated blood loss was 230.00 +/- 109.55 mL. Two intraoperative complications were recorded. The median number of extracted pelvic and para-aortic lymph nodes was 23 (range, 12-36) and 7 (range, 3-15), respectively. The mean T SD time before Foley catheter removal was 5.6 +/- 2.74 days (range, 3-14 days), and bladder voiding function recovery to grade 0 to grade 1 was observed in 26 patients (92.9%). Of the 28 patients, 3 patients received further adjuvant therapy. The median follow-up period was 38 (range, 4-62) months for all patients. No recurrence case was found in this series.Conclusion: Laparoscopic nerve-sparing radical parametrectomy is a therapeutic option for occult early-stage invasive cervical cancer discovered after hysterectomy. Nerve-sparing radical surgery in indicated patients may lead to optimal preservation of bladder function.