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Nerve sparing radical hysterectomy in early stage cervical cancer. Latest developments and review of the literature.

ΤίτλοςNerve sparing radical hysterectomy in early stage cervical cancer. Latest developments and review of the literature.
Publication TypeJournal Article
Year of Publication2015
AuthorsKavallaris, A., Zygouris D., Dafopoulos A., Kalogiannidis I., & Terzakis E.
JournalEur J Gynaecol Oncol
Volume36
Issue1
Pagination5-9
Date Published2015
ISSN0392-2936
Λέξεις κλειδιάFemale, Humans, Hysterectomy, Organ Sparing Treatments, Peripheral Nerve Injuries, Urinary Bladder, Urination Disorders, Uterine Cervical Neoplasms
Abstract

BACKGROUND: Cervical cancer is the second most common malignancy of the female genital tract worldwide. Radical hysterectomy with pelvic lymphadenectomy exemplifies the treatment of choice for early stage disease, whereas even if it is performed by gynaecologist-oncologist, still has the drawback of significant postoperative morbidity, especially for urinary bladder function. Nerve-sparing radical hysterectomy (NSRH) is a technique in which the neural part of the cardinal ligament which encloses the inferior hypogastric plexus, as well as the bladder branch (distal part of the plexus), remains intact. By this way, the bladder's innervation is safe and its functional recovery is more rapid. There is sufficient data to support the feasibility of the technique via laparotomy and laparoscopy, as well as the effectiveness related to the postoperative bladder dysfunction compared to conventional radical hysterectomy. On the other hand, the evidence related to survival outcomes is weak and derives from non-randomized trials. However, the low rate of local relapses after NSRH in early stage disease (IA2-IB1) with tumor diameter less than two cm makes the procedure suitable for this group of patients.CONCLUSION: According to the current evidence NSRH seems to be a suitable technique for gynaecologist-oncologist familiar with the method in early stage cervical cancer. It is a technique which improves significantly postoperative bladder recovery and the patients' quality of life (QoL), without compromising the oncological standard.

Alternate JournalEur. J. Gynaecol. Oncol.
PubMed ID25872326

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