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Voiding recovery after radical parametrectomy in cervical cancer patients: An international prospective multicentre trial - SENTIX
I. Zapardiel, R. Kocian, C. Köhler, J. Klat, A. Germanova, A. Jacob, S. Bajsova, G. Böhmer, L. Lay, B. Gil-Ibañez, P. Havelka, B. Kipp, G. Szewczyk, R. Tóth, JC. Staringer, J. De Santiago, PJ. Coronado, R. Poka, R. Laky, M. Luyckx, M. Fastrez, L....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
- MeSH
- dospělí MeSH
- hysterektomie škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory děložního čípku chirurgie MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
OBJECTIVE: Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial. METHODS: The SENTIX trial (47 sites, 18 countries) is a prospective study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer. Overall, the data of 300 patients were analysed. Voiding recovery was defined as the number of days from surgery to bladder catheter/epicystostomy removal or to post-voiding urine residuum ≤50 mL. RESULTS: The median voiding recovery time was three days (5th-95th percentile: 0-21): 235 (78.3%) patients recovered in <7 days and 293 (97.7%) in <30 days. Only seven (2.3%) patients recovered after >30 days. In the multivariate analysis, only previous pregnancy (p = 0.033) and type of parametrectomy (p < 0.001) significantly influenced voiding recovery >7 days post-surgery. Type-B parametrectomy was associated with a higher risk of delayed voiding recovery than type-C1 (OR = 4.69; p = 0.023 vs. OR = 3.62; p = 0.052, respectively), followed by type-C2 (OR = 5.84; p = 0.011). Both previous pregnancy and type C2 parametrectomy independently prolonged time to voiding recovery by two days. CONCLUSIONS: Time to voiding recovery is significantly related to previous pregnancy and type of parametrectomy but it is not influenced by surgical approach (open vs minimally invasive), age, or BMI. Type B parametrectomy, without direct visualisation of nerves, was associated with longer recovery than nerve-sparing type C1. Importantly, voiding dysfunctions after radical surgery are temporary, and the majority of the patients recover in less than 30 days, including patients after C2 parametrectomy.
Departamento de Obstetricia y Ginecología Hospital Clínico San Carlos Madrid Spain
Department of Gynaecology and Obstetrics Hospital Español de Buenos Aires Buenos Aires Argentina
Department of Obstetrics and Gynaecology Cantonal Hospital of Lucerne Lucerne Switzerland
Department of Obstetrics and Gynaecology Institute of Mother and Child Warsaw Poland
Department of Obstetrics and Gynaecology University Hospital Ostrava Ostrava Poruba Czech Republic
Department of Special Operative and Oncologic Gynaecology Asklepios Clinic Hamburg Hamburg Germany
Gynaecologic Oncology Unit La Paz University Hospital IdiPAZ Madrid Spain
Gynaecology Medical University of Graz Graz Austria
Gynecologic Oncology Unit MD Anderson Cancer Centre Madrid Spain
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
Institute of Obstetrics and Gynaecology Faculty of Medicine University of Debrecen Debrecen Hungary
Citace poskytuje Crossref.org
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- $a 10.1016/j.ygyno.2020.12.018 $2 doi
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- $a Zapardiel, Ignacio $u Gynaecologic Oncology Unit, La Paz University Hospital-IdiPAZ, Madrid, Spain. Electronic address: ignaciozapardiel@hotmail.com
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- $a OBJECTIVE: Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial. METHODS: The SENTIX trial (47 sites, 18 countries) is a prospective study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer. Overall, the data of 300 patients were analysed. Voiding recovery was defined as the number of days from surgery to bladder catheter/epicystostomy removal or to post-voiding urine residuum ≤50 mL. RESULTS: The median voiding recovery time was three days (5th-95th percentile: 0-21): 235 (78.3%) patients recovered in <7 days and 293 (97.7%) in <30 days. Only seven (2.3%) patients recovered after >30 days. In the multivariate analysis, only previous pregnancy (p = 0.033) and type of parametrectomy (p < 0.001) significantly influenced voiding recovery >7 days post-surgery. Type-B parametrectomy was associated with a higher risk of delayed voiding recovery than type-C1 (OR = 4.69; p = 0.023 vs. OR = 3.62; p = 0.052, respectively), followed by type-C2 (OR = 5.84; p = 0.011). Both previous pregnancy and type C2 parametrectomy independently prolonged time to voiding recovery by two days. CONCLUSIONS: Time to voiding recovery is significantly related to previous pregnancy and type of parametrectomy but it is not influenced by surgical approach (open vs minimally invasive), age, or BMI. Type B parametrectomy, without direct visualisation of nerves, was associated with longer recovery than nerve-sparing type C1. Importantly, voiding dysfunctions after radical surgery are temporary, and the majority of the patients recover in less than 30 days, including patients after C2 parametrectomy.
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