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Laparoscopic assisted parametrectomy/upper vaginectomy (LPUV)-technique, applications and results
Markus C Fleisch1, Kenneth D Hatch
1Department of Obstetrics and Gynecology, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA.
Gynecologic Oncology
|July 12, 2005
Summary
Laparoscopic parametrectomy/upper vaginectomy (LPUV) offers a safe alternative for unexpected cervical cancer post-hysterectomy or vaginal cuff cancer. While generally safe, potential bladder injuries require careful consideration during this procedure.
Area of Science:
- Gynecologic Oncology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Cervical cancer discovered after hysterectomy or vaginal cuff cancer presents unique treatment challenges.
- Traditional open parametrectomy or radiation therapy are established options.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic parametrectomy/upper vaginectomy (LPUV) for specific gynecologic oncology indications.
- To assess LPUV as an alternative to open surgery or radiation.
Main Methods:
- Retrospective review of 6 patients undergoing LPUV between 1995-2004.
- Patients had unexpected cervical cancer post-hysterectomy or vaginal cuff cancer.
- Data collected on surgical outcomes, complications, and follow-up.
Main Results:
- LPUV was performed for stage Ib(1) (n=5) and Ia(1) (n=1) cervical cancer.
- Mean operative time was 207 minutes with average blood loss of 300 mL.
- One bladder and one bowel injury occurred; no recurrences noted during average 21.5 months follow-up.
Conclusions:
- Laparoscopic parametrectomy/upper vaginectomy is a viable alternative for select patients.
- The procedure is associated with a low risk of recurrence.
- Bladder injury is a specific complication to monitor.