The Impact of Minimally Invasive Surgery on Treating Patients with Early Cervical Adenocarcinoma

Abstract

Objective

To explore the impact of minimally invasive surgery on treating patients with early cervical adenocarcinoma (CA).

Methods

From April 2016 to December 2019, patients with early CA and underwent surgery were prospectively included in this study. They were randomly divided into 2 groups: the minimally invasive surgery (MIS) group and conventional laparotomy (CL) group. The baseline characteristics, pathological features, surgical related parameters, serum tumor markers, complications and prognosis were analyzed and compared between the 2 groups. The risk factors for disease free survival (DFS) and overall survival (OS) were also analyzed with logistic regression analyses.

Result

The baseline characteristic and pathological features had no statistical difference between the 2 groups. The mean operation duration in MIS group was significantly longer than CL group (262.39 ± 34.98 vs 241.29 ± 36.98 min, P < 0.001). The intraoperative blood loss volume (189.87 ± 23.87 vs 306.87 ± 24.98 mL, P < 0.001), postoperative anal exhaust time (45.98 ± 4.39 vs 59.87 ± 4.87 days, P < 0.001), catheter removal time (18.29 ± 3.21 vs 21.53 ± 3.19 days, P < 0.001) and length of hospital stay (12.98 ± 2.09 vs 16.98 ± 2.32 days, P < 0.001) were significant lower in MIS group. The serum tumor markers decreased significantly postoperative in both groups with no different levels between the 2 groups. The incidence of complications had no difference between the 2 groups except lymphocysts (P = 0.023). After mean follow up time for 4.23 ± 0.34 years, the DFS rate and OS rate also had no statistical difference between the 2 groups (P = 0.069 and 0.151, respectively).

Conclusion

Extensive hysterectomy with MIS was equally efficacy and safe to CL.

Keywords:

• Extensive hysterectomy
• minimally invasive surgery
• conventional laparotomy
• early cervical adenocarcinoma
• risk factors

View addendum:

Minimally Invasive Surgery for Cervical Cancer: Should We Look beyond Squamous Cell Carcinoma?

Authors’ contributions

HZ and YL contributed to the conception and design of the study; LH M and YF Y performed the experiments, collected and analyzed data; HZ and YL wrote the manuscript; HZ and YF Y revised the manuscript. All authors reviewed and approved the final version of the manuscript.

Ethics approval and consent to participate

The study protocol was approved by the Ethics Committee of Renmin Hospital, Hubei University of Medicine. Informed consent was obtained from all the study subjects before enrollment.

Consent for publication

Not applicable.

Disclosure statement

The authors declare that they have no competing interests.

Availability of data and material

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.