Skip to main content
main-content

13.02.2019 | Urologic Oncology

The Urodynamics and Survival Outcomes of Different Methods of Dissecting the Inferior Hypogastric Plexus in Laparoscopic Nerve-Sparing Radical Hysterectomy of Type C: A Randomized Controlled Study

Zeitschrift:
Annals of Surgical Oncology
Autoren:
MD Lei Li, MD Shuiqing Ma, MD Xianjie Tan, MD Sen Zhong, MD Ming Wu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-019-07228-8) contains supplementary material, which is available to authorized users.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Background

Little data exist about the impact of dissection methods on bladder function during nerve-sparing radical hysterectomy (NSRH). This randomized controlled trial compared the urodynamic and survival outcomes of different methods dissecting the inferior hypogastric plexus (IHP) during laparoscopic NSRH.

Methods

Eligible patients presenting with stage IB cervical cancer from 9 May 2013 to 27 October 2015 were randomized at a ratio of 1:1 and subjected to waterjet (study group) or traditional blunt (control group) dissection of the IHP for laparoscopic type C radical hysterectomy. Participants were subjected to urodynamic evaluations before and after NSRH. The primary measurement was the proportion of patients with residual urine (RU) ≤ 100 ml, while secondary measurements included urodynamic parameters, disease-free survival (DFS), and overall survival (OS).

Results

In total, 191 women met the inclusion criteria, and 160 patients were included in the final analysis, with 80 randomized to each group. At 14 days after NSRH, the study group had more patients with RU ≤ 100 ml than the control group (82.5% vs. 62.5%, p = 0.005). The study group had similar urodynamic outcomes of preoperative and postoperative tests. Comparison with the study group and preoperative tests revealed the control group had significant bladder function impairment at 4 months after NSRH. After a median follow-up of 33 months, the dissection methods had no significant impact on DFS or OS.

Conclusions

Waterjet dissection of the IHP in laparoscopic NSRH resulted in a more rapid return of normal urodynamics without compromising survival outcome.
ClinicalTrials.gov Identifiers NCT03015376 (PUMCH-OBGYN-2013), NCT03291236 (SOCM-1).

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Nicht verpassen: e.Med bis 13. März 2019 100€ günstiger im ersten Jahr!

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Supplementary material 1 (TIFF 456 kb)
10434_2019_7228_MOESM1_ESM.tif
Supplementary material 2 (DOCX 20 kb)
10434_2019_7228_MOESM2_ESM.docx
Different dissection methods for the inferior hypogastric plexus (IHP) did not have an impact on the disease-free survival (A, log rank test P = 0.897) and overall survival (B, log rank test P = 0295) (DOCX 18 kb)
10434_2019_7228_MOESM3_ESM.docx
Literatur
Über diesen Artikel
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

  2. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.


 

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise