Laparoscopic surgery compared to traditional abdominal surgery in the management of early stage cervical cancer

The purpose of the study was to compare laparoscopic total radical hysterectomy with classic radical hysterectomy regarding parametrial, and vaginal resection, and lymphadenectomy.

METHODS

Laparoscopic or laparotomic total radical hysterectomy with advantages and disadvantages was offered to the patients diagnosed as having operable cervical cancer between 2007 and 2010. Lymph node status, resection of the parametria and vagina, and margin positivity were recorded for both groups. Data were collected prospectively. Statistical analysis was performed with the SPSS statistical software program.

RESULTS

Totally, 53 cases had classical abdominal radical hysterectomy and 35 laparoscopic radical hysterectomy, respectively. Parametrial involvement was detected in four (11.4%) cases in laparoscopic radical surgery versus nine (16.9%) in laparatomic surgery. All the cases with parametrial involvement had free surgical margins of tumor. Also there were no significant statistical differences in lymph node number and metastasis between the two groups.

CONCLUSION

There is no difference in anatomical considerations between laparoscopic and laparatomic radical surgery in the surgical management of cervical cancer.

Association of first trimester low PAPP-A levels with adverse pregnancy outcomes

OBJECTIVE

To investigate whether first trimester low PAPP-A levels are associated with adverse pregnancy outcomes.

METHODS

A case control retrospective study including 663 pregnant women whose gestational age ranged between 11 and 14 weeks attending prenatal care at Akdeniz University Hospital was carried out. Chromosomal abnormalities, spontaneous abortions, and multiple pregnancies were excluded from the study. Finally 318 singleton pregnancies were included in this study. Pregnant women whose PAPP-A levels were < or =10th percentile were compared with PAPP-A levels > 10'h percentile for the frequency of pregnancy complications such as SGA, preeclampsia, preterm delivery, gestational diabetes mellitus and gestational hypertension.

RESULTS

The most common complication of pregnancy was SGA (9.4%, n=30). There was no significant association between low PAPP-A levels and incidence of subsequent pregnancy outcomes. Maternal age was found to be a risk factor for gestational diabetes (p = 0.00). Small for gestational age was significantly associated with nulliparity and smoking during pregnancy (p = 0.03 and p = 0.01, respectively).

CONCLUSION

First trimester of low PAPP-A level (< or = 10th percentile) was not associated with SGA, preeclampsia, preterm delivery, gestational hypertension or gestational diabetes mellitus.