Design: Comparative analyses encompassed patient characteristics, parameters of surgical quality and treatment outcomes.

Setting: Only one 2-2.5cm umbilical incision was required for LESS-RH (Trendelenburg Lithotomy position). A 15-20 cm vertical midline incision was required for ARH ( supine position).

Patients or Participants: This retrospective study utilized a propensity score-matched cohort design, comprising 142 patients diagnosed with cervical cancer at FIGO stage I to II, who underwent surgical procedures performed by the same team between Jan. 2017 and Dec. 2020. The LESS-RH group (n=71) was matched 1:1 with the ARH group based on propensity scores.

Interventions: All patients underwent radical hysterectomy and pelvic lymph node dissection.

Measurements and Main Results: The matched cohort mostly comprised IB1 (68 cases) and IIA1 (54 cases). Squamous cell carcinoma was the predominant pathology(110/142). In the ARH group, average estimated blood loss was significantly higher than in the LESS-RH group (200ml vs. 100ml; P<0.05). The median surgical time was shorter in the ARH group than in the LESS-RH group (152 minutes vs. 290 minutes, P<0.05), with respective average lymph node retrieval numbers of 40 and 30 (P<0.05). Other comparison indicators showed no statistically significant differences. The 5-year recurrence-free survival did not significantly differ between the two groups (ARH:84.5%, LESS-RH:84.1%; P=0.76). The ARH group had 8, while the LESS-RH group had 10 cases of pelvic recurrences (P>0.05).

Conclusion: LESS-RH could serve as a feasible alternative to ARH for early-stage cervical cancer management, offering reduced intraoperative blood loss and most minimized incision, while maintaining treatment efficacy.