Volume 21, Issue 4 e14529

THIS ARTICLE HAS BEEN RETRACTED

Open Access

RETRACTED: Effect of laparoscopic-assisted transvaginal hysterectomy on wound complications in patients with early stage cervical cancer: A meta-analysis

Retraction(s) for this article

Jun Zhang,

Jun Zhang

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Yuanhong Zhou,

Yuanhong Zhou

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Hong Ye,

Hong Ye

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Chuanqi Chen,

Corresponding Author

Chuanqi Chen

[email protected]

Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi, China

Correspondence

Youzhen Luo, Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.

Email: [email protected]

Chuanqi Chen, Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, No. 178, Aviation Road, Enshi City 445099, Hubei Province, China.

Email: [email protected]

Search for more papers by this author

Youzhen Luo,

Corresponding Author

Youzhen Luo

[email protected]

orcid.org/0009-0000-9636-8755

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Correspondence

Youzhen Luo, Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.

Email: [email protected]

Chuanqi Chen, Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, No. 178, Aviation Road, Enshi City 445099, Hubei Province, China.

Email: [email protected]

Search for more papers by this author

Jun Zhang,

Jun Zhang

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Yuanhong Zhou,

Yuanhong Zhou

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Hong Ye,

Hong Ye

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Search for more papers by this author

Chuanqi Chen,

Corresponding Author

Chuanqi Chen

[email protected]

Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi, China

Correspondence

Youzhen Luo, Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.

Email: [email protected]

Chuanqi Chen, Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, No. 178, Aviation Road, Enshi City 445099, Hubei Province, China.

Email: [email protected]

Search for more papers by this author

Youzhen Luo,

Corresponding Author

Youzhen Luo

[email protected]

orcid.org/0009-0000-9636-8755

Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China

Correspondence

Youzhen Luo, Department of Gynecology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.

Email: [email protected]

Chuanqi Chen, Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, No. 178, Aviation Road, Enshi City 445099, Hubei Province, China.

Email: [email protected]

Search for more papers by this author

First published: 08 December 2023

https://doi.org/10.1111/iwj.14529

Share a link

Email
Wechat
Bluesky

Abstract

Laparoscopic-assisted vaginal radical hysterectomy (LARVH) and abdominal radical hysterectomy (ARH) have been widely applied to treat cervical carcinoma. But LARVH and ARH have not been fully investigated in treating cervical carcinoma after injury associated with injury. This research is intended to provide an up-to-date basis for comparing LARVH with ARH in early stage cervical carcinoma. Comparison between LARVH and ARH in cervical carcinoma was carried out through a combination of related research. Eligible articles from databases such as PubMed and Embase were screened using an established search strategy. This report covered the results of LARVH versus ARH in cervical carcinoma. The average difference and the 95% confidence interval (CI) were used for the combination of consecutive variables. The combination of categorical variables was performed with the odds ratio (OR) 95% confidence interval. Through the identification of 1137 publications, eight of them were chosen to be analysed. Among them, 363 were treated with LARVH and 326 were treated with ARH. Eight trials showed that LARVH was associated with a reduced risk of postoperative wound infection than ARH (OR, 0.23; 95% CI, 0.1–0.55, p = 0.0009). Five trials showed that there was no difference in the risk of postoperative bleeding after surgery (OR, 1.17; 95% CI, 0.42–3.29, p = 0.76). We also did not differ significantly in the duration of the surgery (OR, 1.79; 95% CI, −6.58 to 10.15, p = 0.68). So, the two surgical methods differ significantly only in the risk of postoperative wound infection.

1 INTRODUCTION

Cervical carcinoma is one of the most frequently fatal gynaecologic malignant tumours that affect women around the world. Over a billion new cases are diagnosed every year in Asia.^1-3 Abdominal radical hysterectomy (ARH), which was first described in the past century, is now considered to be an effective therapy for early stage cervical cancer.^{4, 5} Along with progress in laparoscopy, laparoscopic-assisted vaginal radical hysterectomy (LARVH) became available to treat cervical carcinoma at the end of the 20th century.^{6, 7} The determination of an optimal treatment plan for cervical carcinoma has been difficult because of disputes about LARVH and ARH.^{8, 9}

ARH is one of the longest-term methods, but it seems to have been linked to a greater incidence, for example, of bladder dysfunction, prolonged hospitalization and post-op infections, as demonstrated by the majority of retrospective studies.^10-12 Furthermore, the results of those reviews were comparable among ARH and LARVH, resulting in broad acceptance of LARVH as a standard treatment for early stage cervical cancer.^{13, 14} The Laparoscopic Approach for Cervical Cancer Trial, which was released in 2018, is the first large-scale, clinical trial with ARH versus LARVH, resulting in a significant shift in the recommendations for surgery.¹⁵ Our results showed that LARVH had reduced perioperatively complications than ARH.

Thus, the application of laparoscopy in oncology has many merits such as shortened hospitalization time and fewer bleeding before operation.¹⁶ Nevertheless, LARVH has been shown to add to the complications associated with the operation, for example, the proliferation of lymphocytes and neural damage in the patients.^{17, 18} A recent meta-analyses of ARH and LARVH have shown that LARVH is beneficial in decreasing perioperative complications.¹⁹

A meta-analyses of past research are needed to examine the impact of ARH and LARVH on postoperative wound complications, so as to gain a better understanding of the impact of postcancer surgical treatment.

2 METHODS

2.1 Search strategy

A comprehensive and systematic search for English language articles published up to 2023 was conducted in electronic search engines such as PubMed and other databases. See Figure 1 and Table 1 for more information on the retrieval policy that is used to identify related references. The objective of this review was to find out which trials were performed in early stage cervical carcinoma to compare the results of ARH and LARVH.

Details are in the caption following the image — **FIGURE 1**
Open in figure viewer PowerPoint

Flow chart of the study.

TABLE 1. Search strategy.

No.	Query
#1	Cervical cancer[Title/Abstract] OR Carcinoma of uterine cervix[Title/Abstract] OR Cervical carcinoma[Title/Abstract] OR Carcinoma of cervix [Title/Abstract]
#2	Hysterectomy[Title/Abstract]
#3	Robot[Title/Abstract] OR Computer assisted[Title/Abstract] OR Telerobot[Title/Abstract] OR Remote[Title/Abstract] OR Zeus[Title/Abstract] OR Da Vinci[Title/Abstract] OR Laparoscop*[Title/Abstract] OR Minimally invasive[Title/Abstract] OR Celioscopy[Title/Abstract] OR Peritoneoscopy[Title/Abstract] OR LARVH[Title/Abstract] OR Abdominal[Title/Abstract] OR ARH[Title/Abstract]
#4	Vaginal[Title/Abstract] OR Transvaginal[Title/Abstract]
#5	Pain[All Fields] OR Incision[All Fields] OR Scar[All Fields] OR Cosmetic[All Fields] OR HWES[All Fields] OR Infection[All Fields] OR Dehiscence[All Fields] OR Haemorrhage[All Fields] OR Bleed[All Fields] OR Haematoma[All Fields] OR Wound[All Fields] OR Complication[All Fields]
#6	#1 AND #2 AND #3 AND #4 AND #5

2.2 Selection criteria and methods

The search strategy has been executed on the above-mentioned databases. Studies found in those databases were compared, and duplication was eliminated. The first step was to review the titles and abstracts of the study by the two researchers. Following the removal of those articles that were considered inappropriate for inclusion, the rest were examined closely. In the event that there is a disagreement among both study authors on whether to include or exclude a study, a third MA has been consulted and a consensus has been achieved. Only those trials that fulfilled the eligibility criteria were considered for this analysis. Reference lists for the inclusion of other literature have also been consulted.

2.3 Eligibility criteria

The studies covered were randomized, controlled, cohort or retrospective. In order to be enrolled, the trials in early stage cervical carcinoma were carried out to compare the results of ARH and LARVH with the results of the injury.

2.4 Exclusion criteria

Review articles were excluded. Studies with no related outcome or no comparison with the outcome of the injury following ARH or LARVH were ruled out.

2.5 Data mining and quality assessment

The data were obtained separately from the included trials by the two authors of the trial with a prevalidated data mining template. The methodology was evaluated separately by the two authors with ROBINS-I. Figures 2 and 3.

2.6 Statistical analysis

The meta-analysis was performed with Revman 5.3, which reports an effect size for the odds ratio (OR) for categorical outcomes and a weighted mean difference (MD) for consecutive outcomes. The confidence limits (Cl) were measured with 95% confidence intervals (CIs). I² for the assessment of heterogeneity, and when I² was greater than 50%, a random-effect model was applied. p < 0.05 was taken into account for the reporting of statistical significance. Egger's test was used to evaluate the existence of publication bias in the classification results.

3 RESULTS

3.1 Study characteristics

We found 1137 published papers from 4 databases and eventually chose 8 to be analysed. Six hundred eighty nine were operated on, 363 were treated with LARVH and 326 were treated with ARH. A table of features for the treatment of cervical carcinoma is presented in Table 2. A qualitative evaluation from the literature is presented in Figures 2 and 3.

TABLE 2. Distributional characteristics of selected studies used for meta-analysis.

Study	Year	Country	LARVH	Age	ARH	Age
Benassi et al.²⁰	2002	Italy	60	48 ± 5.3	59	48 ± 5.3
Choi et al.²¹	2012	Korea	89	-	99	-
Jackson et al.²²	2004	UK	50	45.7 (27–81)	50	45.5 (24–86)
Morgan et al.²³	2007	Ireland	30	35 (25–54)	30	38 (20–63)
Naik et al.²⁴	2010	UK	7	38 (20–63)	6	37 (29.5–46)
Pahisa et al.²⁵	2010	Spain	67	51 (29–75)	23	48 (31–67)
Roy et al.²⁶	1996	Canada	25	36 (22–68)	27	38 (28–70)
Sharma et al.²⁷	2006	UK	35	-	32	-

Abbreviations: ARH, abdominal radical hysterectomy; LARVH, laparoscopic-assisted vaginal radical hysterectomy.

3.2 Wound infection

The impact of various surgery methods on postoperative infection of cervical carcinoma was investigated in 8 studies. There was a reduction in the rate of postoperation infection in the patients who received LARVH than in those receiving ARH (OR, 0.23; 95% CI, 0.1–0.55, p = 0.0009), Figure 4.

3.3 Wound haematoma

The influence of various operative methods on the incidence of postoperative bleeding in cervical carcinoma was investigated in five studies. No significant difference was found in the risk of postoperative bleeding in patients who received LARVH or ARH (OR, 1.17; 95% CI, 0.42–3.29, p = 0.76), Figure 5.

3.4 Duration of surgery

The statistics of these three trials showed that there was no difference in operating time among the patients who had received LARVH or ARH (OR, 1.79; 95% CI, −6.58 to 10.15, p = 0.68), Figure 6.

3.5 Publication bias

Publication bias analysis of the studies on the occurrence of wound infection and haematoma in the postoperative period by different surgical procedures in patients with cervical cancer. Figures 7 and 8.

4 DISCUSSION

This research is intended to evaluate the effect of LARVH on the incidence of ARH after operation. We looked at the present research in 4 databases and found 1137 publications, eventually choosing 8 trials to be analysed. Six hundred eighty-nine cases were operated on, 363 were treated with LARVH and 326 were treated with ARH. Eight trials showed that LARVH was associated with a reduced risk of postoperative wound infection than ARH. Five trials showed that there was no difference in the risk of postoperative bleeding between two groups.

The majority of published single trials confirm that LARVH is greater than ARH operation time.^{28, 29} But we do not agree with earlier research that did not indicate that LARVH had a different effect on the number of operations compared with ARH. There is, however, considerable diversity between the inclusion trials, which emphasize operational time. LARVH is more skilled and skilled compared with ARH.^{30, 31} Thus, with the development of laparoscopy techniques and the growing expertise of the surgeon, the operating time might not be the limit of LARVH. Our hypothesis is that this heterogeneity may be due to different surgical techniques and patients' backgrounds. Prospective studies, which may be adapted to the history of the patient and the physician, are required to validate the findings. For LARVH and ARH, the two groups were compared with, for example, operating time. A similar incidence rate is supported by all published studies assessing the complications associated with both open laparoscopy and laparoscopy.²⁵ The incidence of complications varied possibly due to differences in the standard of defining complications and duration of follow-up. Thus, it is necessary to confirm the degree of elimination of parameters and complications in future studies.

This research is limited. First of all, the English thesis and the restricted e-database are searched as the data. Thus, it is possible that some helpful information was omitted. Secondly, the majority of the research was either prospective or retrospective. Retrospective research may reduce the strength of conclusions. This might be a factor influencing the outcome of this meta-analysis.

5 CONCLUSION

In this meta-analysis, LARVH was associated with a reduced incidence of postoperative wound infection in women with cervical carcinoma than in ARH. The incidence of bleeding after operation and the time of operation were not significantly different among LARVH and ARH. This indicates that LARVH is more likely to reduce postoperative wound infections than ARH.

ACKNOWLEDGEMENTS

We thank Prof. Chuanqi Chen and Youzhen Luo for their review of this study.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Open Research

DATA AVAILABILITY STATEMENT

Data available on request from the authors.

REFERENCES

1Olorunfemi G, Ndlovu N, Masukume G, Chikandiwa A, Pisa PT, Singh E. Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012). Int J Cancer. 2018; 143(9): 2238-2249.
10.1002/ijc.31610
CAS PubMed Web of Science® Google Scholar
2Pedersen K, Fogelberg S, Thamsborg LH, et al. An overview of cervical cancer epidemiology and prevention in Scandinavia. Acta Obstet Gynecol Scand. 2018; 97(7): 795-807.
10.1111/aogs.13313
PubMed Web of Science® Google Scholar
3Daniyal M, Akhtar N, Ahmad S, Fatima U, Akram M, Asif HM. Update knowledge on cervical cancer incidence and prevalence in Asia. Asian Pac J Cancer Prev. 2015; 16(9): 3617-3620.
10.7314/APJCP.2015.16.9.3617
PubMed Google Scholar
4Calandra D, Curia JD, Skalej E. Wertheim-Schauta operation in the surgical treatment of carcinoma of the cervix uteri. Sem Med. 1963; 123: 373-374.
CAS PubMed Google Scholar
5Li X, Li J, Wen H, et al. The survival rate and surgical morbidity of abdominal radical trachelectomy versus abdominal radical hysterectomy for stage IB1 cervical cancer. Ann Surg Oncol. 2016; 23(9): 2953-2958.
10.1245/s10434-016-5216-1
PubMed Web of Science® Google Scholar
6Bojahr B, Lober R, Straube W, Kohler G. Gasless laparoscopic-assisted radical vaginal hysterectomy with lymphadenectomy for cervical carcinoma. J Am Assoc Gynecol Laparosc. 1996; 3(4, Supplement): S4-S5.
10.1016/S1074-3804(96)80141-1
CAS PubMed Google Scholar
7Malur S, Possover M, Schneider A. Laparoscopically assisted radical vaginal versus radical abdominal hysterectomy type II in patients with cervical cancer. Surg Endosc. 2001; 15(3): 289-292.
10.1007/s004640000306
CAS PubMed Web of Science® Google Scholar
8Stancu B, Grad NO, Mihaileanu VF, Chiorescu S, Pintea SD, Constantinescu MI. Surgical technique of concomitant laparoscopically assisted vaginal hysterectomy and laparoscopic cholecystectomy. Clujul Med. 2017; 90(3): 348-352.
PubMed Google Scholar
9Tapisiz OL, Dogan AR, Altinbas SK. Vaginal-assisted laparoscopic sacrohysterocervicopexy with retroperitoneal tunneling. Int J Gynaecol Obstet. 2018; 140(1): 118-119.
10.1002/ijgo.12339
PubMed Web of Science® Google Scholar
10Roy M, Plante M, Renaud MC. Laparoscopically assisted vaginal radical hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2005; 19(3): 377-386.
10.1016/j.bpobgyn.2004.12.001
PubMed Web of Science® Google Scholar
11Nam JH, Park JY, Kim DY, Kim JH, Kim YM, Kim YT. Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study. Ann Oncol. 2012; 23(4): 903-911.
10.1093/annonc/mdr360
PubMed Web of Science® Google Scholar
12Malzoni M, Tinelli R, Cosentino F, Fusco A, Malzoni C. Total laparoscopic radical hysterectomy versus abdominal radical hysterectomy with lymphadenectomy in patients with early cervical cancer: our experience. Ann Surg Oncol. 2009; 16(5): 1316-1323.
10.1245/s10434-009-0342-7
PubMed Web of Science® Google Scholar
13Wang YZ, Deng L, Xu HC, Zhang Y, Liang ZQ. Laparoscopy versus laparotomy for the management of early stage cervical cancer. BMC Cancer. 2015; 15: 928.
10.1186/s12885-015-1818-4
PubMed Web of Science® Google Scholar
14Cao T, Feng Y, Huang Q, Wan T, Liu J. Prognostic and safety roles in laparoscopic versus abdominal radical hysterectomy in cervical cancer: a meta-analysis. J Laparoendosc Adv Surg Tech. 2015; 25(12): 990-998.
10.1089/lap.2015.0390
PubMed Web of Science® Google Scholar
15Ramirez PT, Frumovitz M, Pareja R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med. 2018; 379(20): 1895-1904.
10.1056/NEJMoa1806395
PubMed Web of Science® Google Scholar
16Lanowska M, Brink-Spalink V, Mangler M, et al. Vaginal-assisted laparoscopic radical hysterectomy (VALRH) versus laparoscopic-assisted radical vaginal hysterectomy (LARVH) in the treatment of cervical cancer: surgical results and oncologic outcome. Arch Gynecol Obstet. 2014; 289(6): 1293-1300.
PubMed Web of Science® Google Scholar
17Gallotta V, Conte C, Federico A, et al. Robotic versus laparoscopic radical hysterectomy in early cervical cancer: a case matched control study. Eur J Surg Oncol. 2018; 44(6): 754-759.
10.1016/j.ejso.2018.01.092
PubMed Web of Science® Google Scholar
18Luo C, Liu M, Li X. Efficacy and safety outcomes of robotic radical hysterectomy in Chinese older women with cervical cancer compared with laparoscopic radical hysterectomy. BMC Womens Health. 2018; 18(1): 61.
10.1186/s12905-018-0544-x
PubMed Web of Science® Google Scholar
19Zhao Y, Hang B, Xiong GW, Zhang XW. Laparoscopic radical hysterectomy in early stage cervical cancer: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A. 2017; 27(11): 1132-1144.
10.1089/lap.2017.0022
PubMed Web of Science® Google Scholar
20Benassi L, Rossi T, Kaihura CT, et al. Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol. 2002; 187(6): 1561-1565.
10.1067/mob.2002.127596
CAS PubMed Web of Science® Google Scholar
21Choi CH, Lee JW, Lee YY, et al. A comparison of laparoscopic-assisted radical vaginal hysterectomy and laparoscopic radical hysterectomy in the treatment of cervical cancer. J Minim Invasive Gynecol. 2011; 18(6): S3.
10.1016/j.jmig.2011.08.019
Google Scholar
22Jackson KS, Das N, Naik R, et al. Laparoscopically assisted radical vaginal hysterectomy vs. radical abdominal hysterectomy for cervical cancer: a match controlled study. Gynecol Oncol. 2004; 95(3): 655-661.
10.1016/j.ygyno.2004.07.055
CAS PubMed Web of Science® Google Scholar
23Morgan DJ, Hunter DC, McCracken G, McClelland HR, Price JH, Dobbs SP. Is laparoscopically assisted radical vaginal hysterectomy for cervical carcinoma safe? A case control study with follow up. BJOG. 2007; 114(5): 537-542.
10.1111/j.1471-0528.2007.01291.x
CAS PubMed Web of Science® Google Scholar
24Naik R, Jackson KS, Lopes A, Cross P, Henry JA. Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy–a randomised phase II trial: perioperative outcomes and surgicopathological measurements. BJOG. 2010; 117(6): 746-751.
10.1111/j.1471-0528.2010.02479.x
CAS PubMed Web of Science® Google Scholar
25Pahisa J, Martínez-Román S, Torné A, et al. Comparative study of laparoscopically assisted radical vaginal hysterectomy and open Wertheim-Meigs in patients with early-stage cervical cancer eleven years of experience. Int J Gynecol Cancer. 2010; 20(1): 173-178.
10.1111/IGC.0b013e3181bf80ee
PubMed Web of Science® Google Scholar
26Roy M, Plante M, Renaud MC, Tetu B. Vaginal radical hysterectomy versus abdominal radical hysterectomy in the treatment of early-stage cervical cancer. Gynecol Oncol. 1996; 62(3): 336-339.
10.1006/gyno.1996.0245
CAS PubMed Web of Science® Google Scholar
27Sharma R, Bailey J, Anderson R, Murdoch J. Laparoscopically assisted radical vaginal hysterectomy (Coelio-Schauta): a comparison with open Wertheim/Meigs hysterectomy. Int J Gynecol Cancer. 2006; 16(5): 1927-1932.
10.1111/j.1525-1438.2006.00661.x
CAS PubMed Web of Science® Google Scholar
28Pergialiotis V, Rodolakis A, Christakis D, Thomakos N, Vlachos G, Antsaklis A. Laparoscopically assisted vaginal radical hysterectomy: systematic review of the literature. J Minim Invasive Gynecol. 2013; 20(6): 745-753.
10.1016/j.jmig.2013.04.021
PubMed Web of Science® Google Scholar
29Querleu D. Laparoscopically assisted radical vaginal hysterectomy. Gynecol Oncol. 1993; 51(2): 248-254.
10.1006/gyno.1993.1281
CAS PubMed Web of Science® Google Scholar
30Hertel H, Kohler C, Michels W, Possover M, Tozzi R, Schneider A. Laparoscopic-assisted radical vaginal hysterectomy (LARVH): prospective evaluation of 200 patients with cervical cancer. Gynecol Oncol. 2003; 90(3): 505-511.
10.1016/S0090-8258(03)00378-0
PubMed Web of Science® Google Scholar
31Mehra G, Weekes A, Vantrappen P, Visvanathan D, Jeyarajah A. Laparoscopic assisted radical vaginal hysterectomy for cervical carcinoma: morbidity and long-term follow-up. Eur J Surg Oncol. 2010; 36(3): 304-308.
10.1016/j.ejso.2009.08.009
CAS PubMed Web of Science® Google Scholar

Volume21, Issue4

April 2024

e14529

RETRACTED: Effect of laparoscopic-assisted transvaginal hysterectomy on wound complications in patients with early stage cervical cancer: A meta-analysis

Retraction(s) for this article

RETRACTION: Effect of Laparoscopic-Assisted Transvaginal Hysterectomy on Wound Complications in Patients With Early Stage Cervical Cancer: A Meta-Analysis

Abstract

1 INTRODUCTION