Waterjet dissection in the surgical treatment of invasive cervical cancer: functional results


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Abstract

Relevance: Despite the accumulated experience in nerve-sparing pelvic surgery, the rate of functional postoperative complications remains unsatisfactory. Therefore, developing and implementing new surgical approaches may facilitate the surgeon's work and reduce the complication rate. One of these technologies is waterjet surgery. The main advantage of this technique is the selective isolation and preservation of nerve fibers and blood vessels with minimal deformation of the surrounding tissues in the absence of thermal exposure. Objective: To evaluate the functional outcomes in patients with stages IB1-IIB cervical cancer undergoing type C1 radical hysterectomy (nerve-sparing radical hysterectomy) using a waterjet dissector. Materials and methods: The study group included 30 patients who underwent extended type C1 radical hysterectomy using a waterjet dissector. Fifty-two patients of the control group underwent extended type C2 radical hysterectomy. Results: The use of the waterjet dissection in the study group resulted in reduced duration of the postoperative catheterization (2 [2;3] days versus 16 [11.5;20] days) and a shorter time to a postvoid residual volume of urine less than 100 ml (3 [3;4] days versus 21 [20; 25] days) (p<0.001). In the study group, no patient in the postoperative period showed clinical signs of neurogenic bladder dysfunction. Conclusion: Using the waterjet dissection in patients undergoing type C1 radical hysterectomy results in restoration of lower urinary tract functions in a shorter time.

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About the authors

Maria A. Meshkova

P.A. Herzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Centre Ministry of Health of Russia

Ph.D. Student l25284, Russia, Moscow, 2nd Botkinsky str., 3

Svetlana V. Mukhtarulina

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Radiological Centre Ministry of Health of Russia

Email: svmukhtarulina@yandex.ru
Dr. Med. Sci., Head of the Oncogynecology Department 105425, Russia, Moscow, 3rd Parkovaya str., 51

Heda R. Maltsagova

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Radiological Centre Ministry of Health of Russia

Email: hedal6@inbox.ru
Oncologist at the Department of Gynecology with Chemotherapy 105425, Russia, Moscow, 3rd Parkovaya str., 51

Elena G. Novikova

P.A. Herzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Centre Ministry of Health of Russia

Dr. Med. Sci., Professor, Merited Scholar of the Russian Federation, Head of the Department of Reproductive and Urinary Tract Tumors l25284, Russia, Moscow, 2nd Botkinsky str., 3

Andrei D. Kaprin

P.A. Herzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Centre Ministry of Health of Russia; N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Radiological Centre Ministry of Health of Russia

Director General; Director; Chief Non-staff Oncologist of Ministry of Health of Russia 125284, Russia, Moscow, 2nd Botkinsky str., 3

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