Wertheim's operation--a study of 130 cases.
The Hsu's method of radical hysterectomy and lymphadenectomy procedure is a modification of the Okabayashi's radical hysterectomy. It involves the creation of the pararectal and paravesical spaces completely down to the pelvic floor and the excision en block of the uterus with its appendages, the parametria and the entire cardinal ligaments and the upper 1/3 to 1/2 of the vagina with its paracolpia. The vagina is lengthened by the Hsu's technique of suturing the vagina with a Boston suture incorporating the cut margin of the rectal serosa to the posterior rim of the vagina and stitching the visceral peritoneum 2 cm above the cut margin of the rectal serosa. The ovaries are preserved in young patients. Lymphadenectomy involves the dissection of the anterior and posterior chains of the common iliac nodes, the external iliac, obturator, internal iliac and presacral nodes. The author having been trained in the Hsu's method of radical hysterectomy by Professor Hsu himself, conducted a prospective study of the morbidity, sequelae and survival rates of this operation in Singapore. Between January 1982 and July 1987, 130 cases of cancer of the cervix were operated on by the author. Patients who had lymph node metastasis or parametrial infiltration were given adjuvant post operative irradiation. Every patient was followed up personally by the author. Only six patients were lost to follow-up at varying times after operation. Four cases were excluded from analysis. Of the remaining 126 cases, 67 were stage 1B, 20 stage 2A, 36 stage 2B, 2 were central recurrences following radiotherapy and one corpus cancer stage 2. Eleven patients (8.7%) had operative or post-operative morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)
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D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000601:surgery*