26891
document
Pelvic lymphadenectomy for cervical carcinoma : laparotomy extraperitoneal , transperitoneal or laparoscopic approach ? A randomized study . OBJECTIVE To compare transperitoneal , extraperitoneal and laparoscopic pelvic lymphadenectomy in terms of feasibility and morbidity in patients affected by cervical cancer undergoing radical hysterectomy . METHODS Consecutive patients affected by stage IB-IIB cervical carcinoma scheduled for radical surgery entered the study . Patients were randomly assigned to transperitoneal ( TPL ) , extraperitoneal ( EPL ) or laparoscopic pelvic lymphadenectomy ( LPL ) . All patients underwent classical radical hysterectomy . Perioperative data were recorded . Follow up examinations were performed at the 15th , 30th and 60th day after surgery . RESULTS 168 patients entered the study . The mean operative times were : 63+/-7.6 , 54+/-6.7 and 75+/-8.4 min ( TPL vs EPL P < 0.001 ; EPL vs LPL P < 0.001 ; TPL vs LPL P < 0.001 ) for TPL , EPL and LPL respectively . The feasibility of the procedures , analyzed on an intention-to-treat basis , was 96 % , 93 % and 95 % for TPL , EPL and LPL group respectively ( P=ns ) . The average hospitalizations were : 5.6+/-0.9 , 3.2+/-0.4 and 3.1+/-0.3 days ( TPL vs EPL P < 0.001 ; TPL vs LPL P < 0.001 ) for TPL , EPL and LPL respectively . CONCLUSIONS EPL and LPL are as feasible and effective as TPL and can be adequately performed with a reasonable complication rate . LPL showed a statistically significant longer operative time . However , both EPL and LPL can minimize some postoperative complications reducing length of stay .
26892
Intervention_Surgical
radical surgery
26893
Intervention_Surgical
transperitoneal ( TPL )
26894
Intervention_Surgical
extraperitoneal ( EPL )
26895
Intervention_Surgical
laparoscopic pelvic lymphadenectomy ( LPL )
26896
Intervention_Surgical
classical radical hysterectomy
26897
Intervention_Surgical
TPL
26898
Intervention_Surgical
EPL
26899
Intervention_Surgical
TPL
26900
Intervention_Surgical
LPL
26901
Intervention_Surgical
TPL
26902
Intervention_Surgical
EPL
26903
Intervention_Surgical
LPL
26904
Intervention_Surgical
TPL
26905
Intervention_Surgical
EPL
26906
Intervention_Surgical
LPL
26907
Intervention_Surgical
TPL
26908
Intervention_Surgical
EPL
26909
Intervention_Surgical
TPL
26910
Intervention_Surgical
LPL
26911
Intervention_Surgical
TPL
26912
Intervention_Surgical
EPL
26913
Intervention_Surgical
LPL
26914
Intervention_Surgical
EPL
26915
Intervention_Surgical
LPL
26916
Intervention_Surgical
TPL
26917
Intervention_Surgical
LPL
26918
Intervention_Surgical
EPL
26919
Intervention_Surgical
LPL
26920
Outcome_Physical
feasibility and morbidity
26921
Outcome_Other
examinations
26922
Outcome_Other
mean operative times
26923
Outcome_Physical
feasibility of the procedures
26924
Outcome_Other
average hospitalizations
26925
Outcome_Other
feasible
26926
Outcome_Other
effective
26927
Outcome_Other
operative time
26928
Outcome_Other
length of stay
26929
Participant_Condition
cervical carcinoma
26930
Participant_Sample-size
168