A retrospective study on the effect of surgical approaches and uterine manipulators on the prognosis of cervical cancer

Cervical cancer is a common gynecological malignancy. However, the optimal surgical approach and benefits of uterine manipulator use remain unclear in this context. This study aimed to compare patient outcomes among different surgical approaches including laparoscopic, combined vaginal and laparoscopic, abdominal, and robotic using the da Vinci surgical system. Moreover, we also aimed to examine the impact of uterine manipulator use in radical hysterectomy on the outcomes of patients with cervical cancer.

This retrospective study included data from 848 patients with cervical cancer stage IA2–IIA2 that underwent a radical hysterectomy and pelvic lymphadenectomy at the Chinese PLA General Hospital between 2009 and 2019. Patient demographic and clinical characteristics, perioperative findings, and postoperative outcomes were examined.

Patient characteristics, including body mass index, age, FIGO stage, pathological type, and tumor differentiation status and size, were comparable. Five-year survival rates were comparable among the groups that underwent different types of surgery regardless of disease stage. Five-year survival rates were comparable between the groups that underwent surgery with and without the use of a uterine manipulator.

All surgical approaches examined in this study had comparable efficacy and safety profiles. The use of uterine manipulators during radical hysterectomy for cervical cancer does not increase the risk of death.