Comparison of the results of radical hysterectomy: sequential observations in each period.
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.
Kobamatsu
Yoko
Y
Gynecology, Reproductive and Developmental Medicine, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Yamamoto
Ritsu
R
Kaneuchi
Masanori
M
Mitamura
Takashi
T
Minobe
Shinichiro
S
Todo
Yukiharu
Y
Takeda
Mahito
M
Okamoto
Kazuhira
K
Nomura
Eiji
E
Negishi
Hiroaki
H
Sakuragi
Noriaki
N
Fujimoto
Seiichiro
S
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*