IMR Press / EJGO / Volume 42 / Issue 1 / DOI: 10.31083/j.ejgo.2021.01.2319
Open Access Original Research
Outcomes and complications of total laparoscopic hysterectomy after conization
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1 Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, 807-8556 Fukuoka, Japan
Eur. J. Gynaecol. Oncol. 2021 , 42(1), 122–128; https://doi.org/10.31083/j.ejgo.2021.01.2319
Submitted: 20 November 2020 | Revised: 21 December 2020 | Accepted: 24 December 2020 | Published: 15 February 2021
Abstract

Objective: High-grade squamous intraepithelial lesion (HSIL)/cervical intraepithelial neoplasia (CIN) 3, and stage IA1 cervical cancer are often diagnosed after cervical conization. Additional resection is required in some cases, and total laparoscopic hysterectomy (TLH) after conization requires attention due to the postoperative changes around the cervix. Methods: This single-center retrospective study investigated the perioperative outcomes and complications of TLH with or without conization. Patients diagnosed with CIN or stage IA1 cervical cancer were grouped according to whether conization was performed before TLH. The perioperative outcomes, complications, and oncological outcomes were compared for 32 patients who underwent TLH after conization (cone-TLH group) and 18 patients who underwent TLH alone (TLH group). Results: The mean interval between conization and TLH was 14.8 ± 5.2 weeks. There were no significant differences between the cone-TLH and TLH groups in terms of surgical time (186.3 ± 48.1 min vs. 179.8 ± 34.6 min, P = 0.61), blood loss (100 [5-500] mL vs. 100 [5-560] mL, P = 0.79), length of hospital stay (4.7 ± 1.4 days vs. 4.6 ± 1.0 days, P = 0.86), or recurrence rate. One patient in the cone-TLH group experienced a ureter injury. Conclusions: Although the outcomes were comparable between TLH alone and TLH after conization, care is needed to avoid ureter complications.

Keywords
Conization
Total laparoscopic hysterectomy
TLH
Cervical intraepithelial neoplasia
CIN
Cervical cancer
Uterine manipulator
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