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Original Research

Open Access Special Issue

Outcomes and complications of total laparoscopic hysterectomy after conization

  • Kaori Hoshino1,*,
  • Yasuyuki Kinjo1
  • Hiroshi Harada1
  • Taeko Ueda1
  • Yoko Aoyama1
  • Midori Murakami1
  • Seiji Kagami1
  • Yusuke Matsuura1
  • Kiyoshi Yoshino1

1Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, 807-8556 Fukuoka, Japan

DOI: 10.31083/j.ejgo.2021.01.2319 Vol.42,Issue 1,February 2021 pp.122-128

Submitted: 20 November 2020 Accepted: 24 December 2020

Published: 15 February 2021

(This article belongs to the Special Issue Minimally Invasive Surgery in Gynecologic Oncology)

*Corresponding Author(s): Kaori Hoshino E-mail:


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.


Conization; Total laparoscopic hysterectomy; TLH; Cervical intraepithelial neoplasia; CIN; Cervical cancer; Uterine manipulator

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Kaori Hoshino,Yasuyuki Kinjo,Hiroshi Harada,Taeko Ueda,Yoko Aoyama,Midori Murakami,Seiji Kagami,Yusuke Matsuura,Kiyoshi Yoshino. Outcomes and complications of total laparoscopic hysterectomy after conization. European Journal of Gynaecological Oncology. 2021. 42(1);122-128.


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