Key result
Laparoscopic radical hysterectomy resulted in a significantly greater postoperative reduction in heart rate variability, including a greater decrease in RMSSD (-18.7 vs -7.8, p=0.002), compared to open surgery in patients with early cervical cancer.
Why the study?
The mechanisms underlying the higher risk of recurrence and death in early cervical cancer patients undergoing minimally invasive versus open surgery remain unclear.
Does laparoscopic surgery compared to open surgery negatively impact heart rate variability in patients with early cervical cancer?
Cohort (n=68)
No
Does laparoscopic surgery compared to open surgery negatively impact heart rate variability in patients with early cervical cancer?
Laparoscopic radical hysterectomy for early cervical cancer leads to a greater reduction in heart rate variability compared to open surgery, suggesting a more negative impact on cardiac autonomic regulation.
Answers are grounded in this paper and cite their sources.
Associated with greater postoperative HRV reduction after laparoscopy; hypothesis-generating and should not yet change surgical decisions.
Background Evidence suggests that the risk of recurrence and death in patients with early cervical cancer (ECC) undergoing minimally invasive surgery is significantly higher than that in patients undergoing open surgery. However, the mechanisms underlying such a difference remain unclear. Heart rate variability (HRV) represents autonomic nerve activity, which is related to tumorgenesis and can be used as a prognostic indicator for various cancers. The main purpose of this study was to explore the difference in the effects of laparoscopic and open surgery on HRV in ECC patients. Methods A total of 68 ECC (FIGO IA1 with lymphovascular space invasion -IIA2) patients undergoing radical hysterectomy for the first time (84% open group vs. 16% laparoscopic group) were included. A single-lead micro-ECG recorder was used to collect 5 min electrocardiograms 1 day before the operation and 3 days after the operation, and then HRV time domain and frequency domain indices were analyzed, including mean heart rate (MeanHR), maximum heart rate (MaxHR), minimum heart rate (MinHR), the standard deviation of all normal-to-normal intervals (SDNN), the root mean square of successive interval differences (RMSSD), very low-frequency power (VLF), low-frequency power (LF), high-frequency power (HF), total power (TP), and the ratio of LF to HF (LF/HF). Results Heart rate (i.e., MeanHR, MaxHR, and MinHR) were significantly higher, and HRV (i.e., SDNN, RMSSD, LF, HF, and TP) were significantly lower after the operation than before the operation in both the laparoscopic and open groups (P < 0.05). The postoperative reduction in RMSSD and HF was significantly higher in the laparoscopic group than in the open group (P < 0.05). Conclusions These data suggest that radical hysterectomy can lead to increased heart rate and decreased HRV in patients with ECC, which can negatively affect cardiac autonomic regulation. Compared with open surgery, laparoscopic surgery has a greater negative impact on the HRV of ECC patients.
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Liu et al. (2022) conducted a cohort in Early cervical cancer (n=68). Laparoscopic radical hysterectomy vs. Open radical hysterectomy was evaluated on Postoperative reduction in RMSSD (root mean square of successive interval differences) (p=0.002). Laparoscopic radical hysterectomy resulted in a significantly greater postoperative reduction in heart rate variability, including a greater decrease in RMSSD (-18.7 vs -7.8, p=0.002), compared to open surgery in patients with early cervical cancer.
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