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Abstract
Aim. The aim of the conducted study is to determine the possibility and efficacy of surgical treatment for cervical cancer in the early stages by laparoscopically assisted lymphadenectomy with simultaneous transvaginal hysterectomy according to Schauta-Amreich as an alternative to laparotomy surgeries.
Materials and methods. Since 2019 to 2021, 21 patients were operated by applying the laparoscopically assisted lymphadenectomy with simultaneous transvaginal hysterectomy according to Schauta-Amreich; at the same time, extended radical abdominal hysterectomy, and Wertheim-Meigs operation were performed on 22 patients with stage IA2-IB1 cervical cancer. Clinical baseline data in the two study groups showed no significant differences (p>0.05).
Results. On the basis of the results obtained and statistically significant differences between the compared criteria, it has been revealed that laparoscopically assisted lymphadenectomy with simultaneous transvaginal hysterectomy according to Schauta-Amreich caused less blood loss (261.9 vs. 310.9 ml, average difference –49.0 ml), was shorter in the duration of hospital stay (7.0 versus 8.0 bed-days, average difference –1.0 bed-days), as well as demonstrated lower pain scores on the visual analog scale (5.38 vs 6.77, average difference 1.39). The group of patients who underwent laparoscopically assisted lymphadenectomy with simultaneous transvaginal hysterectomy according to Schauta-Amreich, showed higher incidence of lymphorrhea than in the alternative group of the study, however, the number of cases of lymphocysts formation was greater in patients who underwent radical abdominal hysterectomy. These adverse events may delay further radiation therapy performance.
Conclusion. The introduction mini-invasive surgery into oncological practice expands the possibilities for surgeons to perform nerve-sparing operations without negative effect on radicalness and reduced survival in gynecological cancer patients.
The quality of life level of patients who underwent laparoscopic surgery is significantly higher than that of patients who undergone the traditional surgical approach, especially in the context of physical and emotional well-being.
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