Understanding the limits of parametrial resection in radical hysterectomy: a randomized controlled trial

Introduction: The aim was to evaluate whether adding specific educational medical illustrations may help gynecologists to better understand the limits of parametrial resection in radical hysterectomy from type A to type C2. Study Design: randomized controlled trial. Material and methods: Institute of Obstetric and Gynecologic Pathology, University of Catania, Italy. Materials and methods: 30 senior Obstetrics and Gynecology (Ob/Gyn) residents and 30 general Ob/Gyn consultants were enrolled in the study, and randomized to two groups of 15 people (group A and group B). Both groups had a copy of the article on the Querleu-Morrow Classification of Radical Hysterectomy (2017) for reading comprehension. Group B also had 10 unpublished medical illustrations, prepared for this paper. After one month the level of self-perceived understanding related to parametrectomy limits in radical hysterectomy was evaluated in both groups using a numeric visual analog scale, where each participant evaluated his degree of comprehension. The data were statistically analyzed using the U Mann-Whitney test. Results: Group A participants (only article) had a lower level of comprehension of parametrectomy limits compared to group B participants (article plus drawings). The difference between the mean scale score, reported by group A, equal to 5.9 ±1.4, and that reported by group B, equal to 7.2 ±1.5, was statistically significant (p < 0.01). Conclusions: The results of this study suggest that educational materials, such as the proposed drawings, may help both Ob/Gyn consultants and residents to better understand the relationship between the extent of parametrial resection and cervical disease severity, and the related postoperative complications.