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Article
A Novel Technique to Minimize Contamination for Cervical Cancer Surgery Patients.
J Minim Invasive Gynecol
  • Martin A Martino, MD, Lehigh Valley Health Network
  • Kristin Bixel, Ohio State University
  • Andrea M Johnson, Lehigh Valley Health Network
  • Taylor Wejkszner, Lehigh Valley Health Network
  • Aaron Jacobs, Lehigh Valley Health Network
  • Jose Lazaro, MD, Lehigh Valley Health Network
  • Elizaveta Makarova, Lehigh Valley Health Network
  • M Bijoy Thomas, MD, Lehigh Valley Health Network
  • Jeffrey Fowler, Ohio State University
Publication/Presentation Date
11-1-2020
Abstract

The Laparoscopic Approach to Cervical Cancer (LACC) trial changed the surgical management of cervical cancer worldwide. It was a multinational phase III clinical trial that reported lower survival and higher rate of abdominopelvic recurrences in minimally invasive surgery (MIS) than those of open surgery after hysterectomy. It is possible that tumor exposure to the peritoneal cavity in the MIS arm may account for these differences. We propose a novel technique to minimize peritoneal contamination of malignant cells present at the cervical os by placing a vaginal cerclage abdominally to create a seal at the apex of the vagina during MIS radical hysterectomy. The 2 patients in this work remain healthy and disease-free more than 18 months after surgery using this novel technique. We intend this work to serve as a platform both for offering a safe alternative to the open approach supported by the LACC trial and, most importantly, for promoting discussion of the results of the LACC trial and further research on surgical techniques in the treatment of cervical cancer. MIS has repeatedly been shown to have lower rates of infection, fewer complications, and shorter hospital stays while providing oncologic care that is noninferior to open approach.

PubMedID
31931144
Document Type
Article
Citation Information

Martino, M. A., Bixel, K., Johnson, A. M., Wejkszner, T., Jacobs, A., Lazaro, J., Makarova, E., Thomas, M. B., & Fowler, J. (2020). A Novel Technique to Minimize Contamination for Cervical Cancer Surgery Patients. Journal of minimally invasive gynecology, 27(7), 1624–1630. https://doi.org/10.1016/j.jmig.2020.01.006