Slow-transit constipation after radical hysterectomy type III.
BACKGROUND
This study investigated ways to reduce the rate of slow-transit constipation after radical hysterectomy type III.


METHODS
A prospective study was conducted involving 59 consecutive patients with cervical cancer stage IB1-IIIA at high risk for parametrial or lymph node involvement who were treated between May 1996 and March 1999 by laparoscopically assisted radical vaginal hysterectomy type III.


RESULTS
During laparoscopic transection of the cardinal ligament, particular attention was focused on conservation of the pelvic splanchnic nerves. After vaginal removal of the uterus, a vaginal sacrocolporectopexy was performed transvaginally. Nerve preservation and pexy of the rectum allowed a significant reduction of postoperative constipation, as compared with classic radical hysterectomy without conservation of the splanchnic pelvic nerves and without sacrocolporectopexy.


CONCLUSIONS
Refinements in the preparation of the parasympathetic nerves during radical pelvic surgery and refixation of the terminal rectum helps to prevent postoperative constipation.
Possover
M
M
Department of Gynecology and Obstetrics, University of Cologne, Kerperner Strasse 34, 50931 Cologne, Germany. Marc.Possover@medizin.uni-koeln.de
Schneider
A
A
D003248:Constipation / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D005260:Female; D005726:Ganglia, Parasympathetic / Q000601:surgery; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D011446:Prospective Studies; D012007:Rectum / Q000294:innervation; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery