title: Postoperative surgical complications of lymphadenohysterocolpectomy.
abstract: Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. METHODS AND RESULTS PATIENTS WERE DIVIDED ACCORDING TO THE TYPE OF SURGERY PERFORMED AS FOLLOWS: for cervical cancer - group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer.
  
  
  BACKGROUND
  PRS- Piver Rutledge-Smith, II- class II, III- class III.
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: F
authors.initials: F
authors.lastname: Marin
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: M
authors.initials: M
authors.lastname: Pleşca
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: C I
authors.initials: CI
authors.lastname: Bordea
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: S C
authors.initials: SC
authors.lastname: Voinea
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: I
authors.initials: I
authors.lastname: Burlănescu
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: E
authors.initials: E
authors.lastname: Ichim
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: C G
authors.initials: CG
authors.lastname: Jianu
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: R R
authors.initials: RR
authors.lastname: Nicolăescu
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: M P
authors.initials: MP
authors.lastname: Teodosie
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: K
authors.initials: K
authors.lastname: Maher
authors.affiliation: Department of Surgical Oncology II, " Prof. Dr. Al Trestioreanu " Institute of Oncology, Bucharest.
authors.forename: A
authors.initials: A
authors.lastname: Blidaru
mesh_terms: D005260:Female; D006406:Hematoma / Q000473:pathology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods*; D008209:Lymphedema / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology*; D011300:Preoperative Care / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D012383:Romania; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000473:pathology; D014594:Uterine Neoplasms / Q000601:surgery*; D014624:Vaginal Fistula / Q000473:pathology
keywords: cervical cancer; lymphadenohysterocolpectomy; postoperative complications; radical hysterectomy; uterine cancer