Laparoscopy versus laparotomy for the management of early stage cervical cancerReportar como inadecuado




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BMC Cancer

, 15:928

First Online: 24 November 2015Received: 10 May 2015Accepted: 16 October 2015DOI: 10.1186-s12885-015-1818-4

Cite this article as: Wang, Y., Deng, L., Xu, H. et al. BMC Cancer 2015 15: 928. doi:10.1186-s12885-015-1818-4

Abstract

BackgroundThe possible advantages of laparoscopic radical hysterectomy LRH versus open radical hysterectomy RH have not been well reviewed systematically. The aim of this study was to systematically review the comparative effectiveness between LRH and RH in the treatment of cervical cancer based on the evaluation of the Perioperative outcomes, oncological clearance, complications and long-term outcomes.

MethodsThe systematic review was conducted by searching PubMed, MEDLINE, EMBASE, the Cochrane Library and BIOSIS databases. All original studies that compared LRH with RH were included for critical appraisal. Data were pooled and analyzed.

ResultsA total of twelve original studies that compared LRH n = 754 with RH n = 785 in patients with cervical cancer fulfilled quality criteria were selected for review and meta-analysis. LRH compared with RH was associated with a significant reduction of intraoperative blood loss weighted mean difference = −268.4 mL 95 % CI −361.6, −175.1; p < 0.01, a reduced risk of postoperative complications OR = 0.46; 95 % CI 0.34–0.63 and shorter hospital stay weighted mean difference = −3.22 days; 95 % CI–4.21, −2.23 days; p < 0.01. These benefits were at the cost of longer operative time weighted mean difference = 26.9 min 95 % CI 8.08–45.82. The rate of intraoperative complications was similar in the two groups. Lymph nodes yield and positive resection margins were similar between the two groups. There were no significant differences in 5-year overall survival HR 0.91, 95 % CI 0.48–1.71; p = 0.76 and 5-year disease-free survival hazard ratio HR 0.97, 95 % CI 0.56–1.68; p = 0.91.

ConclusionsLRH shows better short term outcomes compared with RH in patients with cervical cancer. The oncologic outcome and 5-year survival were similar between the two groups.

KeywordsLaparoscopic radical hysterectomy Abdominal radical hysterectomy Meta-analysis Cervical cancer AbbreviationsLRHLaparoscopic radical hysterectomy

RHOpen radical hysterectomy

RCTsRandomized controlled trials

LAVHLaparoscopic assisted vaginal radical hysterectomy

FIGOInternational Federation of Gynecology and Obstetrics

DFSDisease free survival

OSOverall survival

LVSILymph vascular space invasion

Yao Zhang and Zhi-qing Liang contributed equally to this work.

Electronic supplementary materialThe online version of this article doi:10.1186-s12885-015-1818-4 contains supplementary material, which is available to authorized users.

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Autor: Yan-zhou Wang - Li Deng - Hui-cheng Xu - Yao Zhang - Zhi-qing Liang

Fuente: https://link.springer.com/







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