Minimally invasive surgery of no tumor containment for cervical cancer surgery

Abstract The aim of this study is to evaluate the oncologic outcomes of minimally invasive radical hysterectomy with no tumor containment. Between January 2017 and June 2020, we recruited 350 women with early stage of cervical cancer, all eligible patients were informed of the potential complications and benefits of abdominal radical hysterectomy and laparoscopic radical hysterectomy. All patients in our study were refrain from using uterine manipulator, myoma drill or uterus suture combined with protective vaginal closure of the colpotomy such as clamp, vaginal cuff or vaginal suture instead, put the specimen in a collection bag, and extraction of the collection bag via the vagina. This research was approved by the Ethics Committee of Jinhua Municipal Central Hospital (2020 − 268). Over a median follow-up of 51 (range 30–72) months period, there were 5 patients lost to follow-up, and 3 patients refused to treatment after surgery. A total of 342 women with cervical cancer were ultimately analyzed in our study. Initial International Federation of Gynecology and Obstetrics (FIGO) 2018 stage was IA1 lymphovascular space invasion (LVSI+) 22 (6.29%), IA2 36 (10.29%), IB1 137 (39.14%), IB2 126 (36%), IIA1 14 (4%) and IIIC1p 15 (4.29%) respectively, and histology was squamous cell in 269 (76.86%), adenocarcinoma in 75 (21.43%), and adenosquamous in 6 (1.71%) patients. Lymphovascular invasion was confirmed in 80 (22.86%) patients. Lymph nodes were tumor-free in 325 (92.86%) patients. After radical hysterectomy, 83 (23.71%) patients underwent adjuvant chemoradiation or/and radiation. After a median follow-up of 51 (range 30–72) months, we noted the disease-free survival and overall survival rate were 95.71% (335/350) and 98.86% (346/350) respectively. The technique of minimally invasive surgery using maneuvers to avoid peritoneal contamination during surgery provides excellent oncologic outcome for patients with early cervical cancer. Our retrospective data suggest that laparoscopical surgery may be oncologically safe and may be validated in further randomized trials.