title: [Intrafascial hysterectomy ("CISH" method; cervical intrafascial Semm hysterectomy)--can the risk of cervix stump carcinoma be calculated?].
abstract: The incidence of the carcinoma of the cervical stump is reported in the literature between 0.1-3%. The operative treatment as well as the radiation therapy is more difficult and complicated in relation to the cervical malignancy of an "intact" uterus. On the other hand the supracervical uterus-amputation offers advantages versus the classical hysterectomy. So many endoscopic experienced groups prefer this operative technique. SEMM performs an additional stanza of the cervix and corpus in order to remove the cervical adenocells. This procedure was simulated with the help of an in vitro model to answer the question of facultative adenocells in the remaining cervix. 41 uteri and the resected stanzas were histologically examined. Adenocells could be detected in 68.3 % of the cervical hulls. The transformation zone could be resected totally in all cases. Taking into account these results we can conclude, that the combination of the supracervical hysterectomy with a cervix-corpus-stanza could reduce the risk of a cervical stump-carcinoma. Because of remaining adenocells in the cervical hull, this special carcinoma-risk can't be excluded after an interval of at least 20-25 years.
authors.affiliation: Klinik und Poliklinik für Gerburtshilfe und Frauenheilkunde, Johannes-Gutenberg-Universität Mainz.
authors.forename: D
authors.initials: D
authors.lastname: Kruczynski
authors.forename: U
authors.initials: U
authors.lastname: Schäffer
authors.forename: T
authors.initials: T
authors.lastname: Beck
authors.forename: W
authors.initials: W
authors.lastname: Weikel
authors.forename: P G
authors.initials: PG
authors.lastname: Knapstein
mesh_terms: D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation*; D007045:Hysterectomy, Vaginal / Q000295:instrumentation; D011183:Postoperative Complications / Q000473:pathology*; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears