Laparoscopic assisted radical vaginal hysterectomy for cervical carcinoma: Morbidity and long-term follow-up

ObjectivesTo study the feasibility, morbidity and outcome of cervical cancer patients treated with laparoscopic assisted radical vaginal hysterectomy (LARVH).MethodsThe study group included 53 women with cervical cancer (stage-Ib). They included women undergoing LARVH at the joint cancer-centres between 1994 and 2002. Data was collected on operating-time, nodal-yield, hospital-stay, complications recurrence rate and survival rate. The group was followed up until 2006.ResultsOf 53 women who were selected for LARVH, in 2 women LARVH was abandoned when nodes were positive at frozen section. The median age was 42 years while the operating-time was 210 min with a nodal-yield of 23 and a hospital-stay of 5 days. Final histology revealed 10 women with lympho-vascular invasion, 1 nodal metastases and invasion of parametrium/vagina in 2 women. 7 received adjuvant radiotherapy. 3 had chemo-radiation. Complications included voiding difficulty (6), urinary tract infection (5), pyrexia (4), haemorrhage (2), pain (1), port-site haematoma (1) and nerve injury (1). Late complications included lymphoedema (4), urinary incontinence (4), voiding-problems (2), lymphocyst (1), venous-thrombosis (1) and rectocele (1). The median follow-up was 41 months. 4 women had recurrence, of which 3 women died. The five-year survival was 89%.ConclusionsVaginal radical hysterectomy with laparoscopic pelvic lymphadenectomy is feasible and safe with regards to mortality and has low morbidity.