[Renaissance of vaginal hysterectomy for cervical carcinoma. 100th anniversary of the first abdominal radical surgery of cervical carcinoma by Ernst Wertheim on November 16, 1898].
In the 100 year long history of the abdominal radical operation of collum carcinoma, due to the continued clinical surgical and scientific work of several generations of physicians, abdominal radical operation with standardized pelvic lymphonodectomy has become the method of choice for surgical treatment of collum carcinoma since 1970. Vaginal radical operation in its various forms has since played only a very restricted role in surgical treatment of collum carcinoma. According to the opinion of the majority of cancer surgeons vaginal radical operation had to be abandoned in view of discontinuous spreading of carcinoma into the regional pelvic lymph nodes. Because of its simplicity vaginal radical operation would still be useful today for very old high-risk patients and very young women with early invasive collum carcinoma detected in cancer screening. In view of our knowledge of the lymph node problem in collum carcinoma, however, this can no longer be the vaginal radical operation of past generations. In order to prevent critical objections to vaginal radical operation, the early attempts of Stoeckel, Suboth Mitra, Bastiaanse, Navratil, Inguilla, and Akashi were resumed. Since 1989 attempts have been made to combine vaginal radical operation of collum carcinoma with laparoscopic pelvic or para-aortic lymphonodectomy. The development has passed the following stages: the development of laparoscopic pelvic and para-aortic lymphonodectomy based on staging criteria the combination of laparoscopic lymphonodectomy with vaginal radical operation of collum carcinoma the combination of laparoscopic lymphonodectomy with complete laparoscopic radical hysterectomy and only subsequent vaginal removal of organs.
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Abteilung für Gynäkologie, Frauenklinik des Krankenhauses Berlin-Neukölln, Bundesrepublik Deutschland.
Börner
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D001317:Austria; D005260:Female; D006176:Gynecology / Q000266:history / Q000639:trends; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007044:Hysterectomy / Q000266:history* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000266:history* / Q000379:methods / Q000639:trends; D010535:Laparoscopy / Q000266:history; D002583:Uterine Cervical Neoplasms / Q000266:history* / Q000601:surgery
Zur Renaissance der vaginalen Radikaloperation des Collumkarzinoms. Zum 100. Jahrestag der ersten abdominalen Radikaloperation eines Collumkarzinoms durch Ernst Wertheim am 16. November 1898.