Comparison of modified Cherney incision and vertical midline incision for management of early stage cervical cancer.

Abstract

OBJECTIVE: The aim of this study was to compare operative feasibility and surgical outcome of the modified Cherney incision and vertical midline incision in patients undergoing radical hysterectomy and pelvic lymphadenectomy.

METHODS: Between March 2005 and December 2007, retrospective data of 78 patients (n=17; modified Cherney incision, n=61; vertical midline incision) with early stage cervical cancer who received radical hysterectomy and pelvic lymphadenectomy were reviewed.

RESULTS: Baseline characteristics of patients who underwent modified Cherney incision and vertical midline incision were similar except for age (mean+/-SD: 32.3+/-3.4 yr vs. 52.5+/-8.4 yr, p<0.001). Patients who received modified Cherney incision had earlier initiation of soft diet (mean+/-SD: 46.5+/-19.5 hr vs. 56.4+/-25.4 hr, p<0.016) and shorter hospital stay compared to those who received vertical midline incision (mean+/-SD: 18.0+/-4.8 days vs. 21.7+/-3.7 days, p<0.042). There was no difference in the number of dissected pelvic lymph nodes, hemoglobin change, postoperative pain, postoperative ileus, Foley indwelling duration, and perioperative complications.

CONCLUSION: Excluding the selection bias for age, there was no significant difference of the clinical outcome between the modified Cherney incision group and the vertical midline incision group. Modified Cherney incision can be cosmetically performed in young age women obtaining equal number of lymph nodes without increased operative morbidity compared to vertical midline incision.