Evaluation of the efficacy of laparoscopic-assisted radical vaginal hysterectomy and abdominal radical hysterectomy for treating cervical cancer: a meta-analysis

Wideochir Inne Tech Maloinwazyjne. 2022 Mar;17(1):69-82. doi: 10.5114/wiitm.2021.106126. Epub 2021 May 14.

Abstract

Introduction: Laparoscopic-assisted radical vaginal hysterectomy (LARVH) and abdominal radical hysterectomy (ARH) are commonly used for cervical cancer treatment. However, the clinical application of LARVH versus ARH in treating cervical cancer remains controversial.

Aim: To investigate the efficacy of LARVH versus ARH in treating cervical cancer via comparing several inductors by pooling related studies.

Material and methods: Eligible articles from PubMed, Embase, and the Cochrane library were screened using established search terms. Consecutive variables were pooled using weighted mean difference (WMD) and 95% confidence interval (CI). Categorical variables were pooled using odds ratio (OR) and 95% CI.

Results: A total of 13 articles were included in this meta-analysis, comprising 579 patients who underwent LARVH and 810 who underwent ARH. LARVH required a longer operation time (WMD = 50.97, 95% CI: 38.34, 63.59, p < 0.001) than ARH. However, compared to patients who underwent ARH, those who underwent LARVH had less bleeding volume (WMD = -311.21, 95% CI: -482.77, -139.64, p < 0.001), required a shorter hospital stay (WMD = -3.38, 95% CI: -5.00, -1.76, p < 0.001), and had a lower risk of urinary tract infection (OR = 0.34, 95% CI: 0.13, 0.89, p = 0.028). Additionally, patients who underwent LARVH showed a slightly lower recurrence rate (OR = 0.549, 95% CI: 0.302, 0.998, p = 0.049) than patients who underwent ARH. However, subgroup analysis results were not in agreement with the pooled results and indicated an unstable outcome.

Conclusions: Owing to these reasons, LARVH has more application prospects than ARH in treating cervical cancer.

Keywords: abdominal radical hysterectomy; cervical cancer; efficacy comparison; laparoscopic-assisted radical vaginal hysterectomy; meta-analysis.