Evaluation Of The Perioperative Complications And Safety Of Different Surgical Approaches After Neoadjuvant Chemotherapy For Local Advanced Cervical Cancer

Objective:To evaluate the surgical complications and safety of different surgical approaches after neoadjuvant chemotherapy for locally advanced cervical cancer.Methods:Medical records of 137 FIGO IB2 and IIA2 locally advanced cervical cancer patients who underwent radical hysterectomy in Affiliated Tumors Hospital of Xingjiang Medical University after neoadjuvant chemotherapy were retrospectively analyzed.54 patients underwent abdominal radical hysterectomy(ARH group),83 patients underwent laparoscopic radical hysterectomy(LRH group).Compare the laparoscopic group to the abdominal group,the number of pelvic lymph nodes removed,the intraoperative blood loss,the number of blood transfusion,the morbidity of the intraoperative complications like bladder,ureter injury,and postoperative complications such as urinary retention,urinary infection,the length of hospital stay and the survival rates.Results:Compare the LRH group to the ARH group,the number of pelvic lymph nodes removed were 26.58±8.61 and 22.98±8.74 respectively,the laparoscopic group was more than that in the abdominal group(P=0.02).The amount of the intraoperative blood loss in the two groups were 142.37±89.40 ml,268.18±238.89 ml,and the LRH group was significantly less than the ARH group(P<0.01).In terms of the number of blood transfusions during surgery,the LRH group was significantly less than that in the ARH group[1(1.20)VS 9(16.67),(P<0.01)].No significant difference was found between the two groups in terms of the morbidity of intraoperative complications and the postoperative complications(P>0.05).In the length of postoperative hospital stay,the LRH group was shorter than that in the ARH group(9.34±2.90 days VS 11.30±3.45 days,P<0.01).The total length of hospital stay of the LRH group was significantly shorter in the ARH group(14.65±5.04 days VS 18.00±7.68 days,P<0.01).Compare the ARH group to the LRH group,There was no significant difference in 1-year survival rates(98.08%,97.30%),2-year survival rates(96.15%,94.59%)and 3-year survival rates(80.00%,81.82%).There was also no significant difference in the survival curves between the two groups(Log-rank?2=0.19,P=0.66).Conclusion:The surgical approaches after neoadjuvant chemotherapy for locally advanced cervical cancer,compared with abdominal radical hysterectomy,laparoscopic radical hysterectomy has less intraoperative bleeding,shorter length of hospital stay and faster recovery after surgery,but there is no significant difference in the influences on the prognosis of the two different surgery approaches.