Efficacy of laparoscopic versus open abdominal radical hysterectomy on stress response and urodynamic status in patients with early cervical cancer

Abstract

Objective: To compare the impact of open abdominal radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) on stress response and urodynamic status of early cervical cancer (CC) patients.

Methodology: Clinical data of 115 patients with early-stage cervical cancer (CC) who underwent surgery at Beijing Shijitan Hospital, Capital Medical University, between December 2021 and June 2024 were retrospectively analyzed. Based on the surgical approach, patients were divided into the ARH group (n = 59) and the LRH group (n = 56). Perioperative status, stress response, and urodynamic indicators before and after the surgery, and the incidence of complications were compared between the two groups.

Results: The perioperative indicators (surgical duration, intraoperative blood loss, anal exhaust duration, number of dissected lymph nodes, and the length of hospital stay) of patients in the LRH group were better than those of the ARH group (P<0.05). After the surgery, the levels of serum angiotensin II (Ang II), growth hormone (GH), and cortisol (Cor) increased in both groups compared to preoperative levels and were significantly lower in the LRH group than in the ARH group (P<0.05). After the surgery, bladder capacity and maximum urethral pressure (MUP) increased, whereas residual urine volume (RUV) decreased in both groups compared with preoperative levels. Patients who underwent LRH had greater bladder capacity and MUP and lower RUV compared to the ARH group (P < 0.05). The incidence of complications in the LRH group was significantly lower than that in the ARH group (P < 0.05).

Conclusions: Compared with ARH, LRH for early CC provides greater benefits in the early postoperative period, including a lower stress response and better improvement in short-term urodynamic indicators.