Application Value of Laparoscopic Radical Hysterectomy Without Pneumoperitoneum and Uterine Lifting in Patients with Stage ⅠA2-ⅠB1 Stage Cervical Cancer

ZHAO Yan; ZHENG Wen; ZHANG Wan

doi:10.3969/j.issn.1004-437X.2026.11.018

Abstract：Objective To investigate the application value of laparoscopic radical hysterectomy without pneumoperitoneum and uterine lifting in patients with stage Ⅰ A2-Ⅰ B1 stage cervical cancer.Methods A total of 60 stage Ⅰ A2-Ⅰ Bl cervical cancer patients who underwent laparoscopic radical surgery at Shangqiu Central Hospital from January 2020 to November 2023 were collected,retrospectively.According to whether pneumoperitoneum was established and uterine lifting device was placed during the operation,28 patients who established pneumoperitoneum and placed uterine lifting device during laparoscopic cervical cancer radical surgery were included in the uterine lifting group,and 32 patients who did not require pneumoperitoneum or uterine lifting device during laparoscopic cervical cancer radical surgery were included in the non-uterine lifting group.Perioperative indicators,rehabilitation progress(first anal exhaust time,catheter removal time,hospital stay),hemodynamic indicators[heart rate,mean arterial pressure(MAP),end expiratory carbon dioxide partial pressure(PetCO2),inspiratory peak pressure(PIP)],postoperative complications,and tumor recurrence were compared between two groups.Results The operation time in non-uterine lifting group was longer than uterine lifting group(P＜0.05),but intraoperative bleeding and lymph node dissection between had no significant difference(P＞0.05).After one hour of surgery,the reduction range of heart rate and MAP in non-uterine lifting group was less than that in uterine lifting group,and the increase range of PetCO2 and PIP was less than that in uterine lifting group(P＜0.05).The first exhaust time,catheter removal time,and hospital stay in the non-uterine lifting group were shorter than those in the uterine lifting group(P＜0.05).The incidence of postoperative complications and 2-year tumor recurrence rate in the non-uterine lifting group were lower than those in the uterine lifting group(P＜0.05).Conclusion Laparoscopic radical surgery without pneumoperitoneum and uterine lifting for Ⅰ A2-Ⅰ Bl stage cervical cancer can maintain stable intraoperative hemodynamics,accelerate the rehabilitation process,reduce incidence of postoperative complications and tumor recurrence rate after 2 years of surgery,and compensate for the high tumor recurrence rate caused by CO2 pneumoperitoneum and uterine lifting during laparoscopic radical surgery,while maintaining conservative surgical efficacy and safety.