Laparoscopic better than abdominal radical hysterectomy for cervical cancer

Laparoscopic radical hysterectomy (LRH) leads to more positive outcomes than abdominal radical hysterectomy (ARH) in the treatment of cervical cancer, reveals a study.

A meta-analysis was conducted to compare the efficacy and safety of LRH and ARH in the treatment of cervical cancer. Two researchers independently searched PubMed and other databases for randomized controlled trials (RCTs) that compared LRH and ARH up to 31 May 2021.

The researchers used the risk of bias assessment tool recommended by Cochrane Library and RevMan 5.3 software for quality assessment and meta-analysis, respectively.

Fourteen RCTs, including a total of 1,700 patients with cervical cancer, met the eligibility criteria. Pooled results showed that LRH, compared with ARH, reduced the intraoperative blood loss (mean difference [MD], ‒58.08, 95 percent confidence interval [CI], ‒70.91 to ‒45.24) and the time to first passage of flatus (MD, ‒14.50, 95 percent CI, ‒16.55 to ‒12.44; p<0.05 for all), and increased the number of lymph nodes removed (MD, 3.47, 95 percent CI, 0.51‒6.43; p=0.02).

No significant between-group differences were seen in the duration of surgery (MD, 27.62, 95 percent CI, ‒6.26 to 61.49), intraoperative complications (odds ratio [OR], 1.10, 95 percent CI, 0.17‒7.32), postoperative complications (OR, 0.78, 95 percent CI, 0.33‒1.86), relapse rate (OR, 1.45, 95 percent CI, 0.56‒3.74), and survival rate (OR, 0.75, 95 percent CI, 0.52‒1.08; p>0.05 for all).

“Still, the long-term effects and safety of LRH and ARH need more high-quality, large-sample RCTs to be further verified,” the researchers said.