Effects of uterine manipulator on the positive rate of vascular tumor thrombus in laparoscopic radical hysterectomy for cervical cancer

Objective To evaluate the effects of uterine manipulator on the positive rate of vascular tumor thrombus in laparoscopic radical hysterectomy for cervical cancer. Methods A xenograft model of cervical cancer Hela cells in nude mice was established. The mice were divided into three groups (n=5). After treatment with the same pressure (1~1.5 kg), cancer and adjacent normal tissues were collected. A total of 101 patients who underwent laparoscopic radical cervical cancer surgery in the Maternal and Child Health Care Hospital Affiliated to Xuzhou Medical University from March 2016 to March 2021 and 68 patients without malignant disease by cervical histopathography during the same period were selected. According to the application of uterine manipulator, they were divided into a hysterotomy group and a hysterotomy free group. Then, CD34-labeled microvessel density (MVD), D2-40-labeled microlymphatic vessel density (MLVD) and the positive rate of vascular tumor thrombus were detected by immunohistochemistry. Results There was no difference in the average positive rate of vascular tumor thrombus in tumor and adjacent normal tissues of nude mice in the three groups (P>0.05), which meant that the time of pressure treatment had no effect on the tumor and adjacent normal tissues under the same pressure (P>0.05). The MVD and MLVD of cervical cancer and adjacent normal tissues were higher than those of normal cervical tissue (P<0.05). The use of uterine manipulator exerted no effect on the positive rate of vascular vessels in cervical cancer and adjacent normal tissues (P>0.05). Conclusions It is safe and feasible to use uterine manipulator in laparoscopic radical hysterectomy of cervical cancer.