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Bai Z, Zuo Y, Huang W, Yao L. Prevalence and Risk Factors of Urinary Retention in Patients With Cervical Cancer: A Meta-analysis and Systematic Review. Cancer Nurs 2024; 47:307-318. [PMID: 36840978 DOI: 10.1097/ncc.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND The literature is inconsistent on the prevalence and risk factors of urinary retention in patients with cervical cancer. OBJECTIVE The aim of this study was to review the literature on the prevalence of urinary retention in patients with cervical cancer and consolidate the risk factors. METHODS For this meta-analysis, eligible articles published in English or Chinese by December 10, 2021, were systematically searched for and retrieved from PubMed, Cochrane Library, Ovid-Embase Medline, Web of Science, PsycINFO, CINAHL, and Scopus. Prevalence, odds ratios (ORs), and 95% confidence intervals (CIs) were used for meta-analysis. RESULTS Twenty-five studies were included in the analysis. The pooled overall prevalence was 0.26 (95% CI, 0.21-0.30, I2 = 95.0%). The identified risk factors were age (OR, 1.13; 95% CI, 1.08-1.19), urinary tract infection (UTI) (OR, 3.33; 95% CI, 1.48-7.49), surgical extent (OR, 2.95; 95% CI, 1.27-6.85), and catheter indwelling time (OR, 3.44; 95% CI, 2.43-3.87). CONCLUSIONS The prevalence of urinary retention in patients with cervical cancer is 0.26. Older age, UTI, longer catheter indwelling time, and a larger surgical extent may increase the risk of urinary retention. Clinicians should identify patients at risk and adopt interventions such as individualized catheter care. IMPLICATIONS FOR PRACTICE Nursing staff should assess the risk of urinary retention in a patient with cervical cancer according to her age, presence of UTI, surgical extent, and catheterization time. A carefully chosen surgical procedure and interventions such as individualized education, timely catheter removal, treatment of UTI, and rehabilitation should be offered.
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Affiliation(s)
- Zhilan Bai
- Author Affiliations: West China School of Nursing, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Woman and Children, Sichuan University, Ministry of Education, West China Second University Hospital (Ms Bai and Mrs Zuo); West China School of Nursing, Sichuan University/West China Hospital Sichuan University (Mrs Huang); and Key Laboratory of Birth Defects and Related Diseases of Woman and Children, Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan, China (Mrs Yao)
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2
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Guo Y, Pan H, Chen S, Tian M, Huang Y, Zhou Y. Effectiveness of acupuncture on urinary retention after radical hysterectomy for cervical cancer in China: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1375963. [PMID: 38903810 PMCID: PMC11187101 DOI: 10.3389/fmed.2024.1375963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Background Cervical cancer is one of the most common malignant tumors worldwide. Radical hysterectomy is the first choice for patients with early-stage cervical cancer. Studies have suggested that acupuncture may be a more effective therapy for the prevention and treatment of urinary retention after radical hysterectomy. Objective To systematically evaluate the clinical efficacy of acupuncture in the prevention and treatment of urinary retention after radical hysterectomy. Methods We searched the Cochrane library, Web of science, PubMed, Embase, Chinese Biomedical Literature Database, Wanfang database, Wipu database, China National Knowledge Infrastructure Database and ClinicalTrials.gov with the time from inception until December 2023, to collect randomized controlled studies on the clinical efficacy of acupuncture for prevention and treatment of urinary retention after radical hysterectomy. Literature meeting criteria was screened for data extraction. Quality evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. And meta-analysis was performed using RevMan5.3 and stata14.0 software. Results 22 Randomized controlled trials with 1,563 patients, 854 in treatment group and 709 in control group, were included totally. Meta-analysis results showed that: the total effective rate in acupuncture group was higher than that in control group, with a statistically significant difference [relative risk (RR)] = 1.43, 95% confidence interval (CI 1.22, 1.68), p < 0.0001; the rate of urinary tract infection in acupuncture group was lower than that in control group, with a statistically significant difference [RR] = 0.23, 95% CI (0.07, 0.78), p < 0.05; the time of indwelling urinary catheter was reduced in acupuncture group compared with control group, with a statistically significant mean difference = -3.45, 95% CI (-4.30, -2.59), p < 0.00001; the incidence of urinary retention was lower in acupuncture group than in control group, and the difference was statistically significant [RR = 0.37, 95% CI (0.27, 0.50), p < 0.00001]; the residual urine volume was reduced in acupuncture group compared with control group, with a statistically significant mean difference = -50.73, 95% CI (-63.61, -7.85), p < 0.00001. Conclusion Acupuncture treatment based on conventional therapy can better prevent and improve urinary retention after radical hysterectomy for cervical cancer, could be a better option for them. Systematic review registration Registered by PROSPERO and the registration number is CRD42023452387.
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Affiliation(s)
- Yong Guo
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Haixia Pan
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Siyang Chen
- The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Minne Tian
- Huizhou First Maternal and Child Health Care Hospital, Guangzhou, Guangdong, China
| | - Yanmei Huang
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou, Guangdong, China
| | - Ying Zhou
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Zhou J, Zhang R, Tang X, Liu S, Jiang X. Urinary retention between nerve-sparing radical hysterectomy and radical hysterectomy for cervical cancer: A meta-analysis. Medicine (Baltimore) 2023; 102:e32985. [PMID: 36862911 PMCID: PMC9981420 DOI: 10.1097/md.0000000000032985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
This study intended to assess the urinary retention between nerve-sparing radical hysterectomy and radical hysterectomy in cervical cancer. Relevant studies were selected from databases of PubMed, Embase, Wanfang, and China National Knowledge Internet with the last report up to January 15, 2022. Hazard ratio (HR) and 95% confidence interval (CI) were chosen as the evaluation index. Heterogeneity was assessed using Cochran Q test and I2 test. Subgroup analysis was conducted based on areas and cancer types (primary and metastatic cancer). A total of 8 articles (retrospective cohort studies) were selected in the meta-analysis. There were significant correlations between nerve-sparing radical hysterectomy and radical hysterectomy in related with urinary retention (HR [95% CI] = 1.78 [1.37, 2.31], P < .001) and (HR [95% CI] = 2.49 [1.43, 4.33], P = .001) of cervical cancer patients. Egger test revealed a significant publication bias (P = .014). Sensitivity analysis via omitting 1 study at each time showed that omission of any study made significant difference (P < .05), indicating reliability and good stability for the analysis. Additionally, there were significant heterogeneities in most subgroups.
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Affiliation(s)
- Jing Zhou
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Rong Zhang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Xiaohui Tang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Suwei Liu
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Xiajuan Jiang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
- * Correspondence: Xiajuan Jiang, Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China (e-mail address: )
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Terada S, Terai Y, Tanaka Y, Tanaka T, Tsunetoh S, Ohmichi M. Postsurgical urodynamic study of total laparoscopic nerve-sparing radical hysterectomy for uterine cervical cancer. J Obstet Gynaecol Res 2022; 48:2863-2871. [PMID: 35934761 DOI: 10.1111/jog.15371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/13/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the impact on urodynamic results between the laparoscopic nerve-sparing radical hysterectomy (LRH) following a step-by-step procedure and abdominal nerve-sparing radical hysterectomy (ARH) for patients with uterine cervical cancer. METHODS This retrospective study enrolled 76 patients with cervical cancer: 35 in the LRH group and 41 in the ARH group. We analyzed their postoperative bladder function in a urodynamics study and examined the volume of resected pelvic nerves contained in parametrial sections using S-100 antibody staining. RESULTS Estimated blood loss and hospital stay after operation for the LRH group were significantly better than those in the ARH group (p < 0.0001). As well, the number of harvested lymph nodes was significantly higher in the LRH group (p = 0.044). There was no difference in perioperative complications between the two groups in this study. The 5-year disease-free survival rates and overall survival rates were 91.2% and 94.0% in the LRH group and 87.8% and 95.1% in the ARH group, both respectively. Although the median residual urine volume were no statistical differences between the LRH group and the ARH group, the recovery of postoperative bladder function (uroflowmetry) in the LRH group rapidly reached presurgery levels at 1 month, and the LRH group had a smaller number of s-100 antibody stained nerves contained the parametrial sections. CONCLUSION We demonstrated that LRH following a step-by-step procedure could achieve a higher level of prevention of damage to the bladder branch of the pelvic splanchnic nerve plexus and thus restore bladder function more rapidly.
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Affiliation(s)
- Shinichi Terada
- Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan
| | - Yoshito Terai
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimichi Tanaka
- Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan
| | - Tomohito Tanaka
- Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan
| | - Satoshi Tsunetoh
- Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan
| | - Masahide Ohmichi
- Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan
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Aleksandrov A, Smith A, Botchorishvili R, Rabischong B. How to dissect the pelvic nerves: from microanatomy to surgical rules. An evidence-based clinical review. Facts Views Vis Obgyn 2022; 14:17-29. [PMID: 35373544 PMCID: PMC9612858 DOI: 10.52054/fvvo.14.1.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Advanced gynaecological procedures often include extensive pelvic dissections, with the nervous structures involved in the disease. Nerve-sparing and preservation is a key factor in reducing postoperative morbidity.
Objectives: The goal of this review is to describe in detail the structure of the pelvic nerves and to gather information from other surgical specialties to give recommendations for safe nerve dissection applied in different gynaecological subspecialties.
Materials and methods: An extensive literature review was carried out in PubMed and Google Scholar. The search included articles concerning peripheral nerve anatomy, mechanisms of injury and different dissection techniques, with the most exhaustive being analysed for the review. Articles from different fields of medicine like orthopaedics, plastic surgery, maxillofacial surgery dealing with peripheral nerve injuries and repair have been reviewed.
Results: The following review demonstrates the in-depth anatomy and mechanism of injury of the peripheral nerves, describes the different techniques for neurolysis and proposes some directions for safe nerve dissection.
Conclusion: When performing complex gynaecological surgeries, the surgeon should avoid unnecessary nerve handling, apply nerve-sparing techniques whenever possible and use the new devices to preserve the nervous structures. Advanced gynaecological surgeries should be performed in specialised centres by expert surgeons with comprehensive knowledge in neuropelveology.
What is new? To our knowledge, this is the first article focused on peripheral nerves that collects data from such a wide range of specialties in order to propose the most comprehensive recommendations that could be applied in pelvic surgery.
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Komatsu H, Okawa M, Hikino K, Iida Y, Osaku D, Kudoh A, Chikumi J, Sato S, Oishi T, Harada T. A simplified procedure of nerve‐sparing radical hysterectomy. J Obstet Gynaecol Res 2022; 48:766-773. [DOI: 10.1111/jog.15154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Hiroaki Komatsu
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Masayo Okawa
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Kohei Hikino
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Yuki Iida
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Daiken Osaku
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Akiko Kudoh
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Jun Chikumi
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Shinya Sato
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
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Ma L, Li Q, Guo Y, Tan X, Wang M, Qi Q. Laparoscopic nerve‑sparing radical hysterectomy for the treatment of cervical cancer: a meta-analysis of randomized controlled trials. World J Surg Oncol 2021; 19:301. [PMID: 34657619 PMCID: PMC8522166 DOI: 10.1186/s12957-021-02408-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/21/2021] [Indexed: 12/29/2022] Open
Abstract
Background The effects and safety of laparoscopic nerve‑sparing radical hysterectomy (LNSRH) and laparoscopic radical hysterectomy (LRH) in cervical cancer treatment remain unclear. This article aims to evaluate the role of LNSRH versus LRH in the treatment of cervical cancer. This is because the updated meta-analysis with synthesized data may provide more reliable evidence on the role of LNSRH and LRH. Methods We searched Pubmed et al. databases for randomized controlled trials (RCTs) involving laparoscopic nerve‑sparing radical hysterectomy (LNSRH) and laparoscopic radical hysterectomy (LRH) for cervical cancer treatment from the inception of databases to June 15, 2021. The RevMan 5.3 software was used for data analyses. This meta-analysis protocol had been registered online (available at: https://inplasy.com/inplasy-2021-9-0047/). Results Thirteen RCTs involving a total of 1002 cervical cancer patients were included. Synthesized results indicated that the duration of surgery of the LNSRH group was significantly longer than that of the LRH group [SMD 1.11, 95% CI (0.15 ~ 2.07), P = 0.02]. The time to intestinal function recovery [SMD −1.27, 95% CI (−1.84 ~ −0.69), P < 0.001] and the time to postoperative urinary catheter removal of the LNSRH group [SMD −1.24, 95% CI (−1.62 ~ −0.86), P < 0.001] were significantly less than that of the LRH group. There were no significant differences in the estimated blood loss [SMD 0.10, 95% CI (−0.14 ~ 0.34), P = 0.41], the length of parauterine tissue resection [SMD −0.10, 95% CI (−0.25 ~ 0.05), P = 0.19], length of vaginal excision [SMD 0.04, 95% CI (−0.26 ~ 0.34), P = 0.78], and incidence of intraoperative adverse events [RR 0.97, 95% CI (0.44 ~ 2.13), P = 0.94] between the LNSRH group and the LRH group. Conclusions LNSRH significantly results in earlier bladder and bowel function after surgery. Limited by sample size, LNSRH should be considered with caution in the future.
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Affiliation(s)
- Linlin Ma
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Qiwei Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Ying Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China.
| | - Xiaoyu Tan
- Department of Obstetrics and Gynecology, Harbin Fifth Hospital, Harbin City, China
| | - Mengying Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Qi Qi
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
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Sim JH, Lee JS, Jang DM, Kim HJ, Lee SW, Cho HS, Choi WJ. Effects of Perioperative Inflammatory Response in Cervical Cancer: Laparoscopic versus Open Surgery. J Clin Med 2021; 10:jcm10184198. [PMID: 34575308 PMCID: PMC8467117 DOI: 10.3390/jcm10184198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 12/31/2022] Open
Abstract
There are few studies between postoperative neutrophil to lymphocyte ratio (NLR) and survival in cervical cancer. We compared postoperative changes in NLR according to surgical methods and analyzed the effect of these changes on 5-year mortality of cervical cancer patients. A total of 929 patients were assigned to either the laparoscopic radical hysterectomy (LRH) (n = 721) or open radical hysterectomy (ORH) (n = 208) group. Propensity score matching analysis compared the postoperative NLR changes between the two groups, and multivariate logistic regression analysis evaluated the association between NLR changes and 5-year mortality. Surgical outcomes between the two groups were also compared. In the LRH group, NLR changes at postoperative day (POD) 0 and POD 1 were significantly lower than in the ORH group after matching (NLR change at POD 0, 10.4 vs. 14.3, p < 0.001; NLR change at POD 1, 3.5 vs. 5.4, p < 0.001). In multivariate logistic regression analysis, postoperative NLR change was not associated with 5-year mortality (2nd quartile: OR 1.55, 95% CI 0.56–4.29, p = 0.401; 3rd quartile: OR 0.90, 95% CI 0.29–2.82, p = 0.869; 4th quartile: OR 1.40, 95% CI 0.48–3.61, p = 0.598), whereas preoperative NLR was associated with 5-year mortality (OR 1.23, 95% CI 1.06–1.43, p = 0.005). After matching, there were no significant differences in surgical outcomes between the two groups. There were significantly fewer postoperative changes of NLR in the LRH group. However, the extent of these NLR changes was not associated with 5-year mortality. By contrast, preoperative NLR was associated with 5-year mortality.
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Affiliation(s)
- Ji-Hoon Sim
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Ju-Seung Lee
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Dong-Min Jang
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
| | - Hwa Jung Kim
- Asan Medical Center, Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Shin-Wha Lee
- Asan Medical Center, Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Hyun-Seok Cho
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
- Correspondence: ; Tel.: +82-2-3010-0807; Fax: +82-2-3010-6790
| | - Woo-Jong Choi
- Asan Medical Center, Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-H.S.); (J.-S.L.); (D.-M.J.); (W.-J.C.)
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Du M, Wang L, Zhao L, Huang W, Fang X, Xia X. Independent Risk Factors of Postoperative Lymphatic Leakage in Patients with Gynecological Malignant Tumor: A Single-Center Retrospective Study. Med Sci Monit 2021; 27:e932678. [PMID: 34226438 PMCID: PMC8272396 DOI: 10.12659/msm.932678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background We aimed this investigation to screen and analyze the risk factors of postoperative lymphatic leakage of gynecological malignant tumors that contribute to the treatment of the diseases. Material/Methods According to the occurrence of lymphatic leakage after an operation, 655 patients with pelvic lymph node and/or abdominal para-aortic lymph node dissection for gynecological malignant tumor were retrospectively analyzed and divided into a case group and a control group. Univariate and multivariate logistic regression analysis were used to screen the effective independent risk factors and establish a clinical prediction model. The differentiation and calibration of the clinical prediction model were evaluated, and we performed internal and external validation of the model with 207 cases. Results The surgeons, the number of removed lymph nodes, the field and range of lymph nodes to be removed, the method of drainage, and postoperative infection are the independent risk factors of lymphatic leakage after lymph node dissection for gynecological malignant tumors. The area under the ROC curve of the clinical prediction model was 0.839 (P<0.001), the calibration Hosmer-Lemeshow test shows χ2=4.381, P=0.821. Through 10-fold cross-validation, the average correct rate of the prediction model was 0.899, the area under the ROC curve of the external verification group was 0.741, and the calibration Hosmer-Lemeshow test showed χ2=12.728, P=0.122. Conclusions The new logistic prediction model showed a good degree of differentiation and calibration in both the modeling and verification groups, and it can be used for early warning of the occurrence of lymphatic leakage after lymph node dissection.
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Affiliation(s)
- Min Du
- Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
| | - Lei Wang
- The NHC Key Laboratory of Carcinogenesis and The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, School of Basic Medical Science, Central South University, Changsha, Hunan, China (mainland)
| | - Liyun Zhao
- Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Wei Huang
- Research Center of Carcinogenesis and Targeted Therapy, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,The Higher Educational Key Laboratory for Cancer Proteomics and Translational Medicine of Hunan Province, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Xiaoling Fang
- Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Xiaomeng Xia
- Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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Magrina J, Yang J, Yi J, Wasson M. Nerve-sparing in Gynecologic Surgery: A Perspective. J Minim Invasive Gynecol 2020; 28:475-480. [PMID: 32702513 DOI: 10.1016/j.jmig.2020.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To provide a perspective on nerve-sparing (NS) surgery in gynecology. DATA SOURCES Literature review, English language. METHODS OF STUDY SELECTION Systematic reviews and meta-analyses studies were selected for review for oncology; comparative studies were selected for endometriosis, and 1 comparative and 1 prospective study were chosen for sacrocolpopexy. TABULATION, INTEGRATION, AND RESULTS Two tables summarize the results of systematic reviews and meta-analyses in oncology. Oncology, endometriosis, and urogynecology sections. Primary benefit of NS technique is decreased bladder dysfunction, and, to a lesser degree, vaginal and rectal dysfunc. CONCLUSION NS is preferable to conventional surgery for benign and malignant conditions to reduce postoperative bladder, rectal, and vaginal dysfunction.
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Affiliation(s)
- Javier Magrina
- Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona (all authors).
| | - Jie Yang
- Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona (all authors); Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Shuaifuyuan Wangfujing Dongcheng District, Beijing, China (Dr. Yang)
| | - Johnny Yi
- Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona (all authors)
| | - Megan Wasson
- Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona (all authors)
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11
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Xu Q, Dong M, Dong W, Yang D, Zhang J, Liu J, Ren L, Feng Y. Postoperative comparison of laparoscopic radical resection and open abdominal radical hysterectomy for cervical cancer patient. Arch Gynecol Obstet 2020; 302:473-479. [PMID: 32495016 DOI: 10.1007/s00404-020-05606-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/18/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE There are limited data regarding postoperative complications and autoimmune reactions caused by surgery in early-stage cervical cancer patients who underwent laparoscopic radical resection (LRR). This study aimed to investigate the therapeutic effect of LRR of cervical cancer patients and its effect on cytokines. METHODS 168 patients with cervical cancer were enrolled. The patients were divided into open group and laparoscopic group according to the random number table method, with 84 cases in each group. The surgical-related indexes and the incidence of complications of the two groups were observed, and the IFN-γ, TNF, and IL-1/2/4/6/8/10/12 levels in peripheral blood were compared before and after surgery in both groups. RESULTS The operation time of the patients in the laparoscopic group was significantly shorter than that in the open group (119.56 ± 45.26 vs. 206.36 ± 54.39, P < 0.01). The intraoperative blood loss in the laparoscopic group was significantly less than that in the open group (155.29 ± 57.58 vs. 529.58 ± 162.4, P < 0.01). The postoperative visual analog scale (VAS) score was also significantly lower than that in the open group (3.65 ± 0.88 vs. 6.32 ± 1.12, P < 0.01). There was no significant difference in the incidence of complications between the two groups. The degree of inflammatory cytokines changes caused by LRR was less than that of open radical surgery (P < 0.001). CONCLUSIONS LRR surgery has less stress on patients with early cervical cancer than open surgery within 5 days after surgery, which has certain reference value for early cervical cancer treatment.
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Affiliation(s)
- Qin Xu
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China
| | - Mingfeng Dong
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,Dali University, Dali, 671003, Yunnan, China
| | - Wei Dong
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China
| | - Dehong Yang
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China
| | - Jie Zhang
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China
| | - Jing Liu
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China
| | - Li Ren
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China. .,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China.
| | - Yun Feng
- Department of Obstetrics and Gynaecology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China. .,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, 650032, Yunnan, China.
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Surgical, Urinary, and Survival Outcomes of Nerve-sparing Versus Traditional Radical Hysterectomy: A Retrospective Cohort Study in China. Am J Clin Oncol 2020; 42:783-788. [PMID: 31490195 PMCID: PMC6766357 DOI: 10.1097/coc.0000000000000593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. The purpose of this retrospective study was to compare the surgical, urinary, and survival outcomes between nerve-sparing radical hysterectomy (NSRH) and traditional radical hysterectomy (TRH) for stage IB cervical cancer, in which all the primary procedures were performed by a single physician.
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13
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Li L, Wu M. ASO Author Reflections: What Is the Future of Nerve-Sparing Radical Hysterectomy? Ann Surg Oncol 2019; 26:662-663. [PMID: 31359281 DOI: 10.1245/s10434-019-07661-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Ming Wu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.
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14
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Paek J, Kang E, Lim PC. Comparative analysis of genitourinary function after type C1 robotic nerve-sparing radical hysterectomy versus type C2 robotic radical hysterectomy. Surg Oncol 2019; 30:58-62. [PMID: 31500786 DOI: 10.1016/j.suronc.2019.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/10/2019] [Accepted: 05/10/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND To compare the return of bladder function and genitourinary complications after type C1 robotic nerve-sparing radical hysterectomy (C1-RRH) to type C2 robotic radical hysterectomy (C2-RRH) in gynecologic cancers. METHODS A retrospective analysis between C1-RRH (n = 42) and C2-RRH (n = 43) was performed. Operative outcomes and perioperative genitourinary complications between the two groups were analyzed. RESULTS The C1-RRH group had shorter hospitalization (0.7 vs. 1.7 days, p < 0.001) and shorter DUC (1 vs. 28 days, p < 0.001). About 76% of C1-RRH group required a catheter for less than 1 week while 84% of the C2-RRH group did for more than 1 week (54% for 1-6 weeks; 30% > 6 weeks). In spite of the short stay after surgery (95% of C1-RRH ≤ 1 day), only two patients (4.8%) in C1-RRH group were admitted again because of urinary tract infection. C1-RRH was only independent predictor for early bladder function return within 1 week after surgery. CONCLUSION The C1-RRH showed early bladder function return and feasible outcomes in spite of early discharge. It can be considered as the first surgical option in gynecologic cancer patients who need RH to preserve their bladder function.
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Affiliation(s)
- Jiheum Paek
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea
| | - Elizabeth Kang
- Department of Gynecologic Oncology and Robotic Surgery, Center of Hope, University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Peter C Lim
- Department of Gynecologic Oncology and Robotic Surgery, Center of Hope, University of Nevada, Reno School of Medicine, Reno, NV, USA.
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15
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Park JY. Additional benefit of minimally invasive surgery to improve functional outcomes after radical hysterectomy. J Gynecol Oncol 2019; 30:e64. [PMID: 30806046 PMCID: PMC6393644 DOI: 10.3802/jgo.2019.30.e64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jeong Yeol Park
- Department of Obstetrics and Gynecologic, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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