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Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomised phase II trial: perioperative outcomes and surgicopathological measurements

  1. R Naik1,
  2. KS Jackson1,
  3. A Lopes2,
  4. P Cross3,
  5. JA Henry3

Article first published online: 12 MAR 2010

DOI: 10.1111/j.1471-0528.2010.02479.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 117, Issue 6, pages 746–751, May 2010

Additional Information

How to Cite

Naik, R., Jackson, K., Lopes, A., Cross, P. and Henry, J. (2010), Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomised phase II trial: perioperative outcomes and surgicopathological measurements. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 746–751. doi: 10.1111/j.1471-0528.2010.02479.x

Author Information

  1. 1

    Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, UK

  2. 2

    Department of Gynaecological Oncology, Royal Truro Hospital, Truro, Cornwall, UK

  3. 3

    Department of Pathology, Queen Elizabeth Hospital, Gateshead, UK

*Mr R Naik, Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX, UK. Email raj.naik@ghnt.nhs.uk

Publication History

  1. Issue published online: 8 APR 2010
  2. Article first published online: 12 MAR 2010
  3. Accepted 30 November 2009.

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Keywords:

  • Cervical cancer;
  • laparoscopic assisted radical vaginal hysterectomy;
  • radical hysterectomy;
  • randomised controlled trial;
  • surgical outcome;
  • surgical resection

Please cite this paper as: Naik R, Jackson K, Lopes A, Cross P, Henry J. Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomised phase II trial: perioperative outcomes and surgicopathological measurements. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02479.x.

Objective  To evaluate perioperative surgical outcomes and resection size for laparoscopically assisted radical vaginal hysterectomy (LARVH) compared with radical abdominal hysterectomy (RAH).

Design  A prospective randomised phase II trial.

Population  Early stage IB cervical cancer requiring radical surgical treatment.

Setting  Northern Gynaecological Oncology Centre, Gateshead, UK.

Methods  Fifteen women were randomised to LARVH and to RAH.

Main outcome measures  Outcomes included requirement in days for bladder catheterisation after surgery, operating time, blood loss, hospital stay, opiate pain relief, complication rate, time to normal activities and resection size of major ligaments and vaginal cuff.

Results  Statistically significant differences were found between LARVH and RAH, respectively: median duration of bladder catheterisation, 4 days versus 21 days (P = 0.003); median operating time, 180 minutes versus 138 minutes (P = 0.05); median blood loss, 400 ml versus 1000 ml (P = 0.05), median hospital stay, 5 days versus 7 days (P = 0.04) and median opiate requirement in the first 36 hours postoperatively, 30 mg versus 53 mg (P = 0.004). The mean resected lengths for LARVH versus RAH, respectively, were: mean resected vaginal cuff, 1.26 cm versus 2.16 cm (P = 0.014); mean resected cardinal ligament length, 1.30 cm versus 2.79 cm (P = 0.013) and mean resected uterosacral ligament length, 1.47 cm versus 4.68 cm (P = 0.034).

Conclusions  This study confirms the short-term surgical benefits of LARVH. In addition, LARVH has been shown to be a less radical procedure than RAH, supporting the need for strict patient selection and to restrict the procedure to small tumours.

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