• Qiuyan Chen, Qicheng Chen, Haikun Yang, and Shifen Dai.
• Qiuyan Chen, Department of Gynecology, Meizhou People's Hospital, Meizhou, Guangdong Province 514000, P.R. China.
• Pak J Med Sci. 2024 Nov 1; 40 (10): 242824312428-2431.

ObjectiveTo evaluate the feasibility and safety of total laparoscopic hysterectomy (TLH) without uterine manipulator for patients with early-stage cervical cancer.MethodsThis study was based on retrospective analysis of clinical data of 72 patients with early-stage cervical cancer who received TLH treatment in Meizhou People's Hospital from January 2018 to December 2020. Of them, 40 patients underwent routine TLH (control group), and 32 patients received TLH without lifting the uterus using uterine manipulator (observation group). Changes in tumor marker levels, human papilloma virus (HPV) status, complications, and survival between two groups of patients were compared.ResultsThere was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). After the surgery, levels of squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), and cancer antigen 125 (CA-125) in both groups of patients were significantly reduced compared to before the surgery, and significantly lower in the observation group compared to the control group at one and two years after the surgery (P<0.05). After three years of postoperative follow-up, there was no significant difference in cumulative survival rates between the two groups (P>0.05).ConclusionsCompared with conventional laparoscopy, hysteroscopy without the use of uterine manipulators can significantly reduce the levels of SCC-Ag, CEA, and CA-125 in patients with early-stage cervical cancer within two years after the surgery, without increasing postoperative complications or affecting survival, and has the same safety.Copyright: © Pakistan Journal of Medical Sciences.

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