Objective:Theaimofthisstudywastoinvestigatethefeasibilityofusingultrasonicscalpelcombinedwithvascularclipinparametrialmanagement,calledlimitedenergyparametrialresection/dissection(LEPRD),inlaparoscopicnerveplane-sparingradicalhysterectomy(NPSRH),amodifiednerve-sparingradicalhysterectomy(NSRH);andtoevaluateitseffectivenessinpelvicautonomicnervepreservation.Methods:FromJuly2012toJanuary2016,257consecutivepatientswithstageIB1toIIA2cervicalcancerwhounderwentNPSRHwereincludedinthisstudy.Patientswerepidedintothreecohortsaccordingtothedifferentparametrialresectionmodality.Theclinical,pathologicalandsurgery-relatedparameterswerecomparedbetweenthethreegroups.Short-andlong-termpostoperativebladderfunctionswereevaluated.Results:LEPRDwasattemptedin94patients,andwassuccessfulin65(69.1%)patients(LEPRDgroup).Theremaining29(30.9%)patientsrequiredbipolarcoagulationafterfailureofvascularclipping(combinedmodalitygroup).Routinebipolarcauterywasusedintheother163patientsduringtheparametrialresection(bipolargroup).ThebloodlossintheLEPRDgroupwassignificantlylowerthanthoseintheothertwogroups(P<0.001).TherateofsuccessfulFoleyremovalonpostoperativeday7wassignificantlyhigherintheLEPRDgroupthaninthebipolargroup(P=0.022).TheincidenceofchronicvoidingdysfunctionwassignificantlylowerintheLEPRDgroupthaninthebipolargroup(P=0.019).Conclusions:ItisfeasibletoperformLEPRDinNPSRHforcervicalcancers.Thiskindoflimitedenergysurgicaltechniqueisassociatedwithlessbloodloss,andleadstoimprovedpostoperativebladderfunction.
