A Novel Technique to Minimize Contamination for Cervical Cancer Surgery Patients.

Publication/Presentation Date

11-1-2020

Abstract

The Laparoscopic Approach to Cervical Cancer (LACC) trial changed the surgical management of cervical cancer worldwide. It was a multinational phase III clinical trial that reported lower survival and higher rate of abdominopelvic recurrences in minimally invasive surgery (MIS) than those of open surgery after hysterectomy. It is possible that tumor exposure to the peritoneal cavity in the MIS arm may account for these differences. We propose a novel technique to minimize peritoneal contamination of malignant cells present at the cervical os by placing a vaginal cerclage abdominally to create a seal at the apex of the vagina during MIS radical hysterectomy. The 2 patients in this work remain healthy and disease-free more than 18 months after surgery using this novel technique. We intend this work to serve as a platform both for offering a safe alternative to the open approach supported by the LACC trial and, most importantly, for promoting discussion of the results of the LACC trial and further research on surgical techniques in the treatment of cervical cancer. MIS has repeatedly been shown to have lower rates of infection, fewer complications, and shorter hospital stays while providing oncologic care that is noninferior to open approach.

Volume

27

Issue

7

First Page

1624

Last Page

1630

ISSN

1553-4669

Disciplines

Obstetrics and Gynecology | Oncology | Plastic Surgery

PubMedID

31931144

Department(s)

Hematology-Medical Oncology Division, Department of Obstetrics and Gynecology, Department of Surgery

Document Type

Article

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