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Objectives: The purpose of this study was to determine the feasibility and radicality of endoscopic radical hysterectomy (ERH) and endoscopic modified radical hysterectomy (EmRH) combined with pelvic lymphadenectomy (ELND) in invasive cervical cancer patients.
Methods: Five patients with invasive cervical cancer underwent ERH or EmRH between May 2003 and March 2007 at Hokkaido University Hospital. Two patients with stage I a adenocarcinoma underwent an EmRH, and two patients with stage I b1 and one patient with stage II a underwent an ERH. All patients gave their informed consent to this experimental procedure before surgery.
Results: The median age of patients was 39 years (range, 33-45 years), and the median body mass index was 20.2 kg/m2 (range, 18.5-23.7 kg/m2). The maximum tumor diameter was 20mm in 1 patient, and ≤10mm in 4 patients. The pathologic subtype was squamous cell carcinoma in 2 patients, and adenocarcinoma in 3 patients. The median operative time was 734 min (range, 583-974 min), the median blood loss was 890 ml(range, 280-2650 ml), the median number of lymph nodes removed was 77 (range, 47-103), and the median length of vaginal cuff removed was 20mm(range, 10-25mm). The median duration of hospitalization post-operatively was 16 days (range, 13-23 days). A post-surgical infection occurred in one patient, but no severe complications were noted. There were no relapses after a mean follow-up period of 31.8 months (range, 15-71 months).
Conclusions: An ERH or EmRH with ELND is feasible and might be beneficial for early invasive cervical cancer.
