Intraperitoneal cytology after laparoscopic radical hysterectomy with vaginal closure without the use of a manipulator for cervical cancer: a retrospective observational study

Abstract

Tomohito Tanaka,1 Shunsuke Miyamoto,1 Shinichi Terada,1 Yuhei Kogata,1 Hiroshi Sasaki,1 Satoshi Tsunetoh,1 Takashi Yamada,2 Masahide Ohmichi11Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan; 2Department of Pathology, Osaka Medical College, Takatsuki, JapanPurpose: Although laparoscopic radical hysterectomy (LRH) has been performed for patients with cervical cancer because of its minimal invasiveness, a recent large prospective study showed that LRH was associated with a lower rate of disease-free survival and overall survival. However, the reason for these results is not apparent. The aim of this study was to evaluate the tumor spillage during LRH with vaginal closure without the use of a manipulator.Patients and methods: Twenty-four patients with cervical cancer underwent total LRH with vaginal closure. To evaluate the leakage of cancer cells during surgery, peritoneal cytology was performed before and after hysterectomy.Results: Among 24 patients with cervical cancer, 2 had stage IA2 disease, 19 had stage IB1 disease and 3 had stage IIA1 disease. Two patients had lymph node metastasis. The median tumor size on final pathology was 9 mm. No cancer cells were identified before or after hysterectomy in any patients.Conclusion: Total LRH with vaginal closure did not increase the propensity for tumor spillage in the peritoneal cavity.Keywords: cervical cancer, laparoscopy, radical hysterectomy, vaginal closure

Keywords

• cervical cancer
• laparoscopy
• radical hysterectomy
• vaginal closure