Wertheim radical hysterectomy. Surgical complications, accuracy of clinical staging and value of lymphangiography in cervical carcinoma.
Wertheim radical hysterectomy combined with pelvic lymphadenectomy was performed at the Helsinki University Central Hospital on 132 women of whom 120 had cervical carcinoma from Stage IA to early IIB and 12 had endometrial carcinoma Stage II. None of the patients died or had severe complications during their hospitalisation. The left ureter was accidently transected in two patients and both were corrected immediately. Wound complications occurred in 16 patients (12%). The high incidence of wound complications is probably partly related to the low-dose heparin prophylaxis. The initial clinical staging was found to be correct in 85% of the cases. Five cases were under-staged. All ten patients cases of early Stage IIB were over-staged, none of whom had parametrial invasion. The predictive value of lymphangiography was low, 14% in histologically positive cases and 89% in negative cases of lymph node metastases. Lymphangiography proved to be only of value in facilitating complete lymph node dissection. Intra-operative lymphangiographic control revealed radio-positive nodes and lead to further dissection in 30 patients (24%).
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007431:Intraoperative Complications; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008220:Lymphography; D008875:Middle Aged; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*