title: Comparison of the results of radical hysterectomy: sequential observations in each period.
abstract: BACKGROUND
  The efficacy of drains and of antibiotics for prophylaxis of postoperative retroperitoneal infections following radical hysterectomy with systematic lymphadenectomy has not yet been adequately investigated.
  
  
  METHODS
  Patients who had just undergone radical hysterectomy were divided into three groups. We used a retroperitoneal drain transvaginally for Groups A (n = 54) and B (n = 55) and transabdominally for Group C (n = 103). Group A was administered a first- and Groups B and C a second- or third-generation cephem antibiotic as the prophylactic antibiotic. We compared the surgery time, blood loss, fever index and febrile morbidity in these three groups.
  
  
  RESULTS
  The average surgery time was Group A 344.2 +/- 13.7 min (mean +/- SE), Group B 425.6 +/- 11.0 min and Group C 528.2 +/- 10.9 min. A significant difference was observed among the groups (p < 0.05). In terms of blood loss during surgery, a significant increase (p < 0.05) occurred in Groups B (2400 +/- 196 g) and C (2373 +/- 130 g) compared with Group A (1820 +/- 122 g). For fever index, Group A showed a value of 36.1 +/- 2.7 dh, Group B 19.9 +/- 2.4 dh and Group C 8.8 +/- 1.5 dh. A significant difference was observed among the groups (p < 0.01). In terms of febrile morbidity, significant differences (p < 0.01, p < 0.0001) were observed between Groups B (14.6%) and C (8.7%) in comparison with Group A (44.4%), respectively.
  
  
  CONCLUSIONS
  In radical hysterectomy with systematic lymphadenectomy, it may be preferable to choose transabdominal drains in the retroperitoneal space and second-generation cephem antibiotics for prophylaxis of postoperative retroperitoneal infections.
authors.affiliation: Gynecology, Reproductive and Developmental Medicine, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kobamatsu
authors.forename: Ritsu
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Mitamura
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Minobe
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Todo
authors.forename: Mahito
authors.initials: M
authors.lastname: Takeda
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Okamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Nomura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Negishi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000517:prevention & control*; D004322:Drainage; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000517:prevention & control*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000601:surgery*