The Impact of Minimally Invasive Surgery on Treating Patients with Early Cervical Adenocarcinoma

Objective: To explore the impact of minimally invasive surgery on treating patients with early cervical adenocarcinoma (CA).

Methods: From April 2016 to December 2019, patients with early CA and underwent surgery were prospectively included in this study. They were randomly divided into 2 groups: the minimally invasive surgery (MIS) group and conventional laparotomy (CL) group. The baseline characteristics, pathological features, surgical related parameters, serum tumor markers, complications and prognosis were analyzed and compared between the 2 groups. The risk factors for disease free survival (DFS) and overall survival (OS) were also analyzed with logistic regression analyses.

Result: The baseline characteristic and pathological features had no statistical difference between the 2 groups. The mean operation duration in MIS group was significantly longer than CL group (262.39 ± 34.98 vs 241.29 ± 36.98 min, P < 0.001). The intraoperative blood loss volume (189.87 ± 23.87 vs 306.87 ± 24.98 mL, P < 0.001), postoperative anal exhaust time (45.98 ± 4.39 vs 59.87 ± 4.87 days, P < 0.001), catheter removal time (18.29 ± 3.21 vs 21.53 ± 3.19 days, P < 0.001) and length of hospital stay (12.98 ± 2.09 vs 16.98 ± 2.32 days, P < 0.001) were significant lower in MIS group. The serum tumor markers decreased significantly postoperative in both groups with no different levels between the 2 groups. The incidence of complications had no difference between the 2 groups except lymphocysts (P = 0.023). After mean follow up time for 4.23 ± 0.34 years, the DFS rate and OS rate also had no statistical difference between the 2 groups (P = 0.069 and 0.151, respectively).

Conclusion: Extensive hysterectomy with MIS was equally efficacy and safe to CL.