Effects of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review

Objective To study the clinical effects of nerve-sparing radical hysterectomy （NSRH） for cervical cancer compared with radical hysterectomy （RH）. Methods We searched the PubMed, EMBASE, CBMdisc, CNKI and Wanfang Data; hand searched related literatures; and collected both randomized controlled trials and controlled clinical trials comparing NSRH with RH for cervical cancer. Meta-analysis was conducted with the Stata software. Results Nineteen clinical controlled trials involving 1 862 patients were collected. Compared with RH, NSRH was much better for the recovery time of post void residual urine volume （PVR） <50 mL and <100 mL, WMD=-6.62, 95%CI （-7.00,-6.23） and WMD=-5.04, 95%CI （-6.52,-3.56） respectively; NSRH has less bladder dysfunction morbidity RR=0.46, 95%CI （0.29, 0.71）; the recovery time of postoperative flatus and bowel movement were much earlier in NSRH than those in the RH group, WMD=-12.02, 95%CI （-16.20,-7.85）, WMD=-20.99, 95%CI （-32.02,-9.96） respectively; no significant difference was found in both survival rate and recurrent rate; one trial showed that NSRH led to less rectal and sexual dysfunction, quality of life in NSRH group was significantly higher than that RH. Conclusions Compared with RH, NSRH is related with better postoperative recovery of bladder, rectal and sexual functions, which can improve the quality of postoperative life, but haven’t lower survival rates and higher recurrence rates. In the future, more prospective randomized controlled trials are required for further investigation.