Objective To assess the efficacy and safety of laparoscopic staging and surgery for patients with cervical cancer.
Methods We searched The Cochrane Library, MEDLINE, EMbase, CBM (from inception to 2009). Randomized controlled trials (RCTs) were identified according to the inclusion and exclusion criteria, and then the quality of included trials was accessed, and the data were extracted. Meta-analysis was performed by RevMan 5.0.2 software.
Results Two RCTs involving 120 participants were included. The results of meta-analyses showed laparoscopic surgery, compared with open surgery, shortened postoperative ileus time (MD= –18.20, 95%CI –22.20 to –14.20, P lt;0.001), reduced the postoperative pain (MD= –1.30, 95%CI –1.86, to –0.74, P lt;0.001) and shortened the overall hospital stay (MD= –1.30, 95%CI –1.59 to –1.01, P lt;0.001). Currently, no evidence supported the superiority of laparoscopic surgery on duration of surgery, number of harvested lymph node and intraoperative blood loss over open surgery. Moreover, the laparoscopic surgery neither increased nor decreased the risk of postoperative complications.
Conclusion The laparoscopic staging and surgery could shorten the recovery time of gastrointestinal function, shorten hospital stay, reduce pain in patients, but have no advantages in postoperative complications, operative time, number of lymph node biopsy, and intraoperative blood loss, compared with open surgery. However, the evidence is not b enough because of the low quality of the included studies. Thus, more high-quality RCTs are required in future.
Citation： YANG Jing,LV Donghao,HE Jia,LIU Hongqian,SHI Gang. Laparoscopic Staging and Surgery for Cervical Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(5): 592-596. doi: 10.7507/1672-2531.20100454 Copy