***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The objectives of this study were to describe our laparoscopic nerve-sparing radical hysterectomy ( LNSRH ) technique and to assess the feasibility and safety of the procedure , as well as its impact on voiding function . We introduce a fascia space dissection technique in order to preserve the pelvic splanchnic nerve , the hypogastric nerve and the bladder branch of the inferior hypogastric plexus under magnification ( ×10.5 ) during laparoscopic radical hysterectomy ( LRH ) with pelvic lymphadenectomy . METHODS From October 2006 to November 2009 , 163 consecutive patients with cervical cancer underwent laparoscopic radical hysterectomy ( LRH ) and pelvic lymphadenectomy , with 82 women undergoing LNSRH with fascia space dissection technique ( LNSRH group ) and 81 undergoing LRH ( LRH group ) . Data from 163 patients were prospect ively collected and compared . Post-operative assessment of bladder function included the following : the time to recover the ability to void spontaneously and to achieve a post-void residual urine ( PVR ) volume of less than 50 ml , with urination function grade d. RESULTS The laparoscopic nerve-sparing radical hysterectomy procedure was completed successfully and was conducted safely in all of the patients . There were no conversions to open surgery in the two groups . The median operative duration in the LNSRH and the LRH groups were 163.52±34.47 min and 132.13±31.42 min , respectively . Blood loss was 142.12±62.38 ml and 187.69±68.63 ml , respectively . The time taken to obtain a post-void residual urine volume of less than 50 ml after removal of the urethral catheter was 7.42±2.35 d ( 5 - 18 d ) in LNSRH group and was 16.75±7.73 d ( 5 - 35 d ) in LRH group ( P<0.05 ) . The bladder void function recovery to Grade s 0-I was 76 ( 92.7 % ) for the LNSRH group and 59 ( 72.8 % ) for the LRH group . A mean follow-up of 22.3 ( 5 - 42 ) months was adhered to , and no patient had a recurrence or metastasis . CONCLUSIONS The technique described in this preliminary study appears to be safe , feasible , and easy in our population , with satisfactory recovery of voiding function OBJECTIVE To investigate bladder and intestinal function recovery and quality of sexual life after  laparoscopic nerve-sparing radical hysterectomy ( LNRH )  for treatment of early invasive cervical carcinoma . METHODS Subjects included patients who underwent radical hysterectomy by laparotomy who were r and omly assigned to 2 groups : 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy ( LRH ) .  We assessed the patients general clinical information , surgical characteristics , pathological findings , and adjuvant therapies . A urodynamic study was used to assess bladder function . Intestinal function recovery and quality of sexual life were evaluated by question naire . RESULTS No significant differences were found in age , surgery characteristics , pathological findings , adjuvant therapies , and main adverse effects between the 2 groups . The mean duration of the postoperative catheterization ( DPC ) in group LNRH was shorter than that in group LRH ( P < 0.001 ) . The maximum flow rate , maximum cystometric capacity , maximum detrusor pressure and urinary complications in group LNRH were better than those in group LRH . The quality of sexual life evaluated according to the female sexual function index ( FSFI ) was better in group LNRH than in those who underwent LRH . The intestinal function of patients in group LNRH also recovered better compared with patients in group LRH OBJECTIVES . The aim of this study was to compare 4 versus 6 courses of adjuvant chemotherapy after neoadjuvant chemotherapy plus radical surgery  in terms of overall survival ( OS ) , disease-free survival ( DFS ) , recurrence rate and toxicity profile . METHODS . We r and omly assigned 200 patients with IB2-IIB cervical cancer to receive 4 ( Group A ) or 6 ( Group B ) courses of cisplatin 100 mg/mq and paclitaxel 175 mg/mq every 21 days . RESULTS . At 4-years follow-up , the comparison of recurrence rate ( p = 1 ; RR = 1.005 ; 95 % CI = 0.87 to 1.161 ) , OS ( p = 0.906 ) and DFS ( p = 0.825 ) did not show statistically significant differences between the two groups . Data analysis showed statistically significant differences between the two groups in term of episodes of leukopenia ( p = 0.0072 ; RR = 1.513 ; 95 % CI = 1.127 - 2.03 ) , anemia ( p = 0.048 ; RR = 1.188 ; CI = 1.012 - 1.395 ) and febrile neutropenia ( p = 0.042 ; RR = 1.119 ; 95 % CI = 1.014 - 1.235 ) , in favor of Group A. As regards non-hematological toxicities , there were no statistically significant differences in terms of gastrointestinal symptoms ( p = 0.49 ; RR = 1.046 ; CI = 0.948 - 1.153 . On the contrary , there was a statistically significant difference regarding neurological symptoms ( p=0.014 ; RR=1.208 ; CI=1.046 - 1.395 ) , that were less frequent in Group A ( 13 % ) than in Group B ( 28 % ) . CONCLUSIONS . Adjuvant treatment with 4 or 6 courses of platinum-based chemotherapy showed similar results in terms of OS and DSF , with a favorable toxicity profile in favor of the first regimen The objective of this study is to describe a technique for preserving the autonomic nerve systematic ally , including the hypogastric nerves , pelvic splanchnic nerves , and pelvic plexus and its vesical branches , based on anatomic considerations for the autonomic nerves innervating the urinary bladder , in radical hysterectomies and to assess postsurgical bladder function . A nerve-sparing radical hysterectomy was carried out on 27 consecutive patients with uterine cervical cancer treated between 2000 and 2002 . The FIGO stages of the disease consisted of 10 stage Ib1 , 6 stage Ib2 , 3 stage IIa , and 8 stage IIb . The nerve-sparing procedure was successfully completed in 22 of the 27 patients ( 81.5 % ) in the study . At 1 year after the operation , bladder symptoms were significantly improved in the nerve-sparing group compared to the non – nerve-sparing group . Urinary incontinence and abnormal ( diminished ) bladder sensation were observed in three of the five patients ( two patients had both symptoms ) , for whom the nerve-sparing procedure could not be performed , but none of the 22 patients for whom the nerve-sparing procedure was performed had incontinence , and only two patients had abnormal ( increased ) bladder sensation ( P = 0.0034 for incontinence and P = 0.030 for abnormal bladder sensation ) . The patients ' survival was not adversely affected by the nerve-sparing procedure . Although it is still preliminary , the surgical technique described in this report is thought to be effective for preserving bladder function , and thus , the quality of life could be improved for patients with cervical cancer who are treated with a radical hysterectomy . For further evaluation of the efficacy of nerve-sparing radical hysterectomy , a prospect i ve r and omized trial needs to be performed OBJECTIVE The study aim ed to evaluate the clinical outcomes of laparoscopic nerve-sparing radical hysterectomy ( LNRH ) for bulky-stage cervical cancer ( lesion ≥ 6 cm ) after neoadjuvant chemotherapy ( NAC )  . METHODS This study prospect i ve recruited patients with pathology-confirmed cervical cancer presenting as a bulky mass ( lesion ≥ 6 cm ) . Subjects included patients who underwent laparoscopic radical surgery .  They were assigned to one of two groups by surgical method : patients who underwent LNRH after NAC and patients who  underwent classical laparoscopic radical hysterectomy ( LRH ) after NAC . We compared the patients ' general clinical characteristics , surgical profiles , pathological findings and adjuvant therapies between the two groups . Recovery of bladder and intestinal function was evaluated by question naire . Patients were followed for up to 1 year to determine the maintenance of effect . RESULTS Compared with patients treated with LRH , patients who underwent LNRH presented no significant differences in age , surgery characteristics , pathological findings , adjuvant therapies or main adverse effects . The mean duration of residual urine < 50 mL in the LNRH group was 11 days , much shorter than that in the LRH group ( 18 days ; P < 0.001 ) . The period of passage of gas by anus was shorter ( 38.9 ± 4.1 h ) in LNRH patients than that in LRH patients ( 56.5 ± 4.0 h ; P < 0.001 ) . The urinary and intestinal symptoms were evaluated 1 year after surgery . The recovery of urinary and intestinal function of patients was better in the LNRH group than in the LRH group . CONCLUSION LNRH is a safe and feasible surgical management for bulky-stage cervical cancer patients ( lesion ≥ 6 cm ) , and after NAC , the urinary and intestinal function of patients in LNRH group showed better recovery compared with functions in the LRH group . The technique is relatively new , and its oncologic efficiency has not yet been fully established . Prospect i ve r and omised controlled studies with an increased number of patients and long-term postoperative follow-up should be carried out to investigate the effect of this therapeutic strategy for bulky-stage cervical cancer OBJECTIVE Surgical therapy for cervical carcinoma carries a significant risk of functional impairment to the bladder . This study evaluates the feasibility and complications of nerve-sparing radical hysterectomy ( NRH )  in Taiwan . METHODS Between March 2010 and March 2011 , consecutive patients diagnosed with early stage cervical cancer ( FIGO stage Ia2 to Ib1 ) and tumor size < 3 cm were recruited prospect ively to undergo NRH or conventional radical hysterectomy ( RH ) . Patients with histories of urinary stress incontinence or bladder dysfunction disease were excluded . A modified Tokyo nerve-sparing radical hysterectomy was performed . RESULTS A total of 30 patients were enrolled . Among these , 18 patients underwent NRH with successful bilaterally nerve-sparing procedures in 15 cases ( 83 % ) , unilaterally nerve-sparing procedures in 2 cases ( 11 % ) , and a failure in 1 case ( 6 % ) . The indwelling catheter was removed on postoperative day 6 . The mean±SD duration from operation to spontaneous voiding was 6.8 ± 1.5 days for women who underwent NRH ; the corresponding duration for women who underwent RH or failed NRH was 20.6 ± 3 days . None of the patients who underwent NRH required intermittent catheterization . All 12 patients who underwent RH needed self-catheterization after discharge . There was a significant reduction in the incidence of postoperative self-catheterization ( p<0.01 ) and bladder dysfunction ( p<0.006 ) . Average satisfaction score analyzed by the Likert-scale question naire was 4.5 for the NRH group and 1.9 for RH group ( p<0.0001 ) . CONCLUSIONS We concluded that the new technique of NRH  can reduce postoperative bladder dysfunctions OBJECTIVE To assess the nerve-sparing radical hysterectomy ( NSRH ) technique and its impact on postoperative voiding function . METHODS Forty-four patients with International Federation of Gynecology and Obstetrics ( FIGO ) stage I b1-IIa cervical cancer were enrolled and r and omized into  NSRH group ( study group , n = 22 ) and  conventional radical hysterectomy ( CRH )  group ( control group , n = 22 ) . The pelvic autonomic nerve pathway ( including hypogastric nerve , pelvic splanchnic nerve , inferior hypogastric plexus and bladder branch ) was completely preserved in the NSRH group . Related parameters were compared between the two groups . RESULTS The estimated blood loss in NSRH group and CRH group were ( 550 + /- 241 ) ml and ( 475 + /- 284 ) ml , respectively , with no significant difference ( P > 0.05 ) . The mean operation time in NSRH group and CRH group were ( 329 + /- 43 ) min and ( 272 + /- 56 ) min , respectively , with a significant difference ( 
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The meta-analyses were conducted using Review Manager version 5.3 software , which is design ed for conducting Cochrane review s. As regards perioperative parameters , NSRH was found to be associated with a lower intraoperative blood loss and a shorter length of hospital stay in comparison with CRH .
Patients undergoing NSRH  experienced lower incidence of urinary , colorectal and sexual dysfunction compared with patients undergoing CRH .
However , the resected parametrial width was favorable in patients with CRH , suggesting that NSRH was inferior to CRH in terms of radicality .
The 5-year disease-free and overall survival rates were similar between the two groups .
In this systematic review and meta- analysis , the collected data to date demonstrated that the nerve-sparing approach guarantees minimized surgical-related pelvic dysfunction , with similar oncological outcomes as CRH .
However , further RCTs should be conducted to confirm the superiority and safety of NSRH