[Analysis of postoperative complications of radical hysterectomy for 219 cervical cancer patients].
OBJECTIVE
To analyze the causes and therapeutic approaches for the complications of radical hysterectomy plus pelvic lymphadenectomy in cervical cancer patients.


METHODS
From Jan. 1995 to Dec. 2003, 219 such patients were treated by radical hysterectomy plus pelvic lymphadenectomy. The stages were: 26 stage IA (17 stage IA1 and 9 stage IA2) (11.9%); 142 stage IB (78 stage IB1, 64 stage IB2) (64.8%); 40 stage IIA (18.3%) and 3 stage IIB (1.4%). 204 patients in this series were treated by radical hysterectomy plus pelvic lymphadenectomy and 15 by modified radical hysterectomy with pelvic lymphadenectomy.


RESULTS
a total of 49 patients (22.4%) developed postoperative complications. The major complications included: bladder dysfunction (10.0%); formation of lymphocysts (7.8%); wound infection (6.8%); hydronephrosis (1.4%) and formation of ureteral fistulas (0.5%). The patients in the group treated by radical hysterectomy plus pelvic lymphadenectomy was likely to develop postoperative complication compared with the patients in the group by modified radical hysterectomy plus pelvic lymphadenectomy (24.0% versus 0, P = 0.067). The postoperative complication incidence in the patients who had preoperative neoadjuvant chemotherapy through intra-arterial catheter or radical radiotherapy in the other hospitals were 50.0% (2/4) and 100.0% (1/1), which were higher than that of the patients treated primarily in our hospital (21.3%, 25.3%) though without statistically significant difference among the groups. Of 52 patients who had previous abdominal surgery history, 13 developed posoperative complications, there was no significant difference between the patients with or without previous abdominal surgery history. The complication incidence of 87 patients treated with preoperative afterloaded radiotherapy was higher than that of 124 patients primarily treated by surgery (25.3% versus 19.4%), but the difference between two groups was statistically not significant (P = 0.239).


CONCLUSIONS
The complication of radical hysterectomy with pelvic lymphadenectomy is correlated with the surgery mode. Preoperative afterloaded radiotherapy may not increase postoperative complication incidence. Properly reducing the extent of surgery may decrease incidence of complications.
Wu
Kun
K
Department of Gynecological Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhang
Wen-hua
WH
Zhang
Rong
R
Li
Hua
H
Bai
Ping
P
Li
Xiao-guang
XG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008197:Lymph Node Excision; D008210:Lymphocele / Q000209:etiology; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D016055:Urinary Retention / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*