Comparison of outcomes between laparoscopic and open radical hysterectomy for early-stage cervical cancer in women with body mass index greater than 24

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-08-14 DOI:10.1111/jog.70041

Lin Xu, Yang Li, Jia Lu

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Abstract

Aim

This is a retrospective cohort study to compare outcomes of laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in overweight and obese women with early-stage cervical cancer.

Methods

The study included 112 patients, with 50 undergoing LRH and 62 undergoing ORH; these were overweight or obese women (BMI ≥24 kg/m²) diagnosed with stage IB–IB2 cervical cancer from 2015 to 2022 Baseline characteristics, including age, smoking status, alcohol consumption, BMI, number of pregnancies, history of abortion, previous abdominal surgeries, menopausal status, radiation therapy, neoadjuvant chemotherapy, clinical tumor stage, tumor grade, or histological subtype, were comparable between the ORH and LRH groups.

Results

LRH was associated with significantly lower intraoperative blood loss (165 mL vs. 604 mL, p < 0.001) and shorter hospital stays (9 vs. 11.5 days, p < 0.001). No significant differences were observed in overall survival and disease-free survival of 1-year, 3-year, and total between the two groups. Complication rates were similar; though, LRH resulted in significantly fewer incidences of wound fat liquefaction.

Conclusion

Despite the technical challenges associated with LRH in obese patients, the procedure demonstrated clear benefits in terms of reduced blood loss and quicker postoperative recovery. The oncological safety of LRH was comparable to ORH, supporting its use as a viable and potentially preferable option for surgical management of early-stage cervical cancer in overweight and obese women.

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体重指数大于24的早期宫颈癌腹腔镜与开放式根治性子宫切除术的疗效比较

目的：本研究是一项回顾性队列研究，比较腹腔镜根治性子宫切除术（LRH）和开放式根治性子宫切除术（ORH）治疗超重和肥胖的早期宫颈癌妇女的疗效。方法纳入112例患者，其中LRH 50例，ORH 62例；这些是2015年至2022年间诊断为IB-IB2期宫颈癌的超重或肥胖妇女（BMI≥24 kg/m2）。基线特征，包括年龄、吸烟状况、饮酒、BMI、怀孕次数、流产史、既往腹部手术、绝经状态、放射治疗、新辅助化疗、临床肿瘤分期、肿瘤分级或组织学亚型，在ORH组和LRH组之间具有可比性。结果LRH显著降低术中出血量（165 mL对604 mL， p < 0.001），缩短住院时间（9天对11.5天，p < 0.001）。两组患者1年、3年、总生存期、无病生存期无统计学差异。并发症发生率相似；然而，LRH导致伤口脂肪液化的发生率明显降低。结论：尽管肥胖患者的LRH存在技术上的挑战，但该手术在减少失血量和加快术后恢复方面显示出明显的益处。LRH的肿瘤安全性与ORH相当，支持其作为超重和肥胖妇女早期宫颈癌手术治疗的可行和潜在优选选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.