Elective cesarean hysterectomy for treatment of cervical neoplasia. An update.
From January 1, 1979, to March 31, 1991, 37 patients underwent elective cesarean hysterectomy for early cervical neoplasia. Thirty-four patients had cervical intraepithelial neoplasia III, and three patients had stage IA-1 squamous cell carcinoma of the cervix. Twenty-eight were primary cesarean sections; nine had obstetric indications. The mean operative time was 128 minutes; mean estimated blood loss was 1,400 mL. One patient experienced an intraoperative hemorrhage (3,500 mL). There were no other recognized intraoperative complications. Four significant postoperative complications included a vaginal cuff abscess, a wound dehiscence and pelvic abscess, one patient with febrile morbidity and an ileus and ligation with partial transection of a ureter. Patients were discharged on a mean of postoperative day 5.7. Although significant complications occurred, we believe that the noncompliant nature of our patient population justifies elective cesarean hysterectomy for treatment of cervical neoplasia.
Hoffman
M S
MS
Department of Obstetrics and Gynecology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa 33612-9497.
Roberts
W S
WS
Fiorica
J V
JV
Angel
J L
JL
Finan
M A
MA
Cavanagh
D
D
D000328:Adult; D002278:Carcinoma in Situ / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002585:Cesarean Section / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D005260:Female; D005334:Fever / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007415:Intestinal Obstruction / Q000209:etiology; D007431:Intraoperative Complications; D011183:Postoperative Complications; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D013529:Surgical Wound Dehiscence; D013530:Surgical Wound Infection; D002583:Uterine Cervical Neoplasms / Q000601:surgery*