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
Published In/Presented At
Martino, M. A., Bixel, K., Johnson, A. M., Wejkszner, T., Jacobs, A., Lazaro, J., Makarova, E., Thomas, M. B., & Fowler, J. (2020). A Novel Technique to Minimize Contamination for Cervical Cancer Surgery Patients. Journal of minimally invasive gynecology, 27(7), 1624–1630. https://doi.org/10.1016/j.jmig.2020.01.006
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