Outcomes and complications of total laparoscopic hysterectomy after conization

Objective: High-grade squamous intraepithelial lesion (HSIL)/cervical intraepithelial neoplasia (CIN) 3, and stage IA1 cervical cancer are often diagnosed after cervical conization. Additional resection is required in some cases, and total laparoscopic hysterectomy (TLH) after conization requires attention due to the postoperative changes around the cervix. Methods: This single-center retrospective study investigated the perioperative outcomes and complications of TLH with or without conization. Patients diagnosed with CIN or stage IA1 cervical cancer were grouped according to whether conization was performed before TLH. The perioperative outcomes, complications, and oncological outcomes were compared for 32 patients who underwent TLH after conization (cone-TLH group) and 18 patients who underwent TLH alone (TLH group). Results: The mean interval between conization and TLH was 14.8 +/- 5.2 weeks. There were no significant differences between the cone-TLH and TLH groups in terms of surgical time (186.3 +/- 48.1 min vs. 179.8 +/- 34.6 min, P= 0.61), blood loss (100 [5-500] mL vs. 100 [5-560] mL, P = 0.79), length of hospital stay (4.7 +/- 1.4 days vs. 4.6 +/- 1.0 days, P = 0.86), or recurrence rate. One patient in the cone-TLH group experienced a ureter injury. Conclusions: Although the outcomes were comparable between TLH alone and TLH after conization, care is needed to avoid ureter complications.