Original Article

Vaginal Stump Ligation for Cervical Cancer

Abstract

Background: We aimed to investigate the effect of vaginal stump ligation in laparoscopic cervical cancer surgery on the prevention of cancer cell detachment.

Methods: The study was conducted from 2010 to 2015, in Xuzhou Maternity and Child Health Care Hospital, Jiangsu Province, China. Seventeen cases of laparoscopic surgery of cervical cancer in control group were observed, and the vaginal stump was irrigated with normal saline after the operation and the washing fluid was searched for cancer cells. Moreover, 43 cases of cervical cancer patients received the same operational procedure, and the vaginal stump was ligated in the surgery and the vagina was incised below the ligature.

Results: The number of cancer cells in the vaginal washing fluid of the experimental group was significantly more than that of the control group. Furthermore, there was no significant difference in the operation time, intraoperative blood loss, the number of pelvic lymph node dissected, vaginal resection length and parametrium resection length. By comparing the postoperative recovery indicators and complications, we found no significant difference in anal exsufflation time, the incidence of vaginal stump infection, the recovery time of postoperative urinary function and incidence of lymphocysts. Finally, there was no significant difference in the quality of life scores between the two groups.

Conclusion: Vaginal stump ligation can reduce cancer cell detachment in cervical cancer surgery, and therefore can help preventing cancer cell implantation and tumor recurrence caused by cancer cell detachment.

 

Undurraga M, Loubeyre P, Dubuisson JB, Schneider D, Petignat P (2010). Early-stage cervical cancer: is surgery better than radiotherapy? Expert Rev Anticancer Ther, 10(3): 451-460.

Hong JH, Tsai CS, Lai CH, Chang TC, Wang CC, Chou HH, Lee SP, Hsueh S (2004). Recurrent squamous cell carcinoma of cervix after definitive radiotherapy. Int J Radiat Oncol Biol Phys, 60(1): 249-257.

Curet MJ (2004). Port site metastases. Am J Surg, 187(6): 705-712.

Li GY (2006). Practical Gynecologic Laparoscopy Surgery (M). Bei Jing: People's Medical Publishing House, 302-338.

Madhusudhan C, Saluja SS, Pal S, Ahuja V, Saran P, Dash NR, Sahni P, Chattopadhyay TK (2009). Palliative stenting for relief of dysphagia in patients with inoperable esophageal cancer: impact on quality of life. Dis Esophagus, 22(4): 331-336.

Tao L, Han L, Li X, Gao Q, Pan L, Wu L, Luo Y, Wang W, Zheng Z, Guo X (2014). Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing. BMC Public Health, 14: 1185.

Ramdass B, Chowdhari A, Koka P (2013). Cancer-initiating cells as target for prevention of recurring disease etiology: role of these malignant putative progenitor cells in relapse or metastasis of human cervical carcinoma. J Stem Cells, 8(3-4): 233-251.

Agostini A, Carcopino X, Franchi F, Cravello L, Lecuru F, Blanc B (2003). Port site metastasis after laparoscopy for uterine cervical carcinoma. Surg Endosc, 17(10): 1663-1665.

Picone O, Aucouturier JS, Louboutin A, Coscas Y, Camus E (2003). Abdominal wall metastasis of a cervical adenocarcinoma at the laparoscopic trocar insertion site after ovarian transposition: case report and review of the literature. Gynecol Oncol, 90(2): 446-449.

Martinez-Palones JM, Gil-Moreno A, Perez-Benavente MA, Garcia-Gimenez A, Xercavins J (2005). Umbilical metastasis after laparoscopic retroperitoneal paraaortic lymphadenectomy for cervical cancer: a true port-site metastasis? Gynecol Oncol, 97(1): 292-295.

Rauvala M, Aglund K, Puistola U, Turpeenniemi-Hujanen T, Horvath G, Willen R, Stendahl U (2006). Matrix metalloproteinases-2 and -9 in cervical cancer: different roles in tumor progression. Int J Gynecol Cancer, 16(3): 1297-1302.

Uren A, Fallen S, Yuan H, Usubutun A, Kucukali T, Schlegel R, Toretsky JA (2005). Activation of the canonical Wnt pathway during genital keratinocyte transformation: a model for cervical cancer progression. Cancer Res, 65(14): 6199-6206.

O-charoenrat P, Sarkaria I, Talbot SG et al (2008). SCCRO (DCUN1D1) induces extracellular matrix invasion by activating matrix metalloproteinase 2. Clin Cancer Res, 14(21): 6780-6789.

Wood SL, Pernemalm M, Crosbie PA, Whetton AD (2014). The role of the tumor-microenvironment in lung cancer-metastasis and its relationship to potential therapeutic targets. Cancer Treat Rev, 40(4): 558-566.

Siegel RL, Miller KD, Jemal A (2015). Cancer statistics, 2015. CA Cancer J Clin, 65(1): 5-29.

Files
IssueVol 46 No 10 (2017) QRcode
SectionOriginal Article(s)
Keywords
Vaginal stump ligation Cervical cancer Laparoscopic surgery

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
YANG Y, LIU Y, LI G, LI L, GENG P, SONG H. Vaginal Stump Ligation for Cervical Cancer. Iran J Public Health. 2017;46(10):1332-1337.