Postoperative surgical complications of lymphadenohysterocolpectomy
Identifieur interne : 002675 ( Main/Exploration ); précédent : 002674; suivant : 002676Postoperative surgical complications of lymphadenohysterocolpectomy
Auteurs : F. Marin ; M. Ple Ca ; Ci Bordea ; Sc Voinea ; I. Burl Nescu ; E. Ichim ; Cg Jianu ; Rr Nicol Escu ; Mp Teodosie ; K. Maher ; A. BlidaruSource :
- Journal of Medicine and Life [ 1844-122X ] ; 2014.
Descripteurs français
- KwdFr :
- Complications postopératoires (anatomopathologie), Femelle, Fistule vaginale (anatomopathologie), Humains, Hystérectomie (), Hystérectomie (effets indésirables), Hématome (anatomopathologie), Lymphoedème (anatomopathologie), Lymphoedème (étiologie), Maladies de la vessie (anatomopathologie), Maladies de la vessie (étiologie), Radiothérapie (), Roumanie, Soins préopératoires (), Tumeurs de l'utérus ().
- MESH :
- anatomopathologie : Complications postopératoires, Fistule vaginale, Hématome, Lymphoedème, Maladies de la vessie.
- effets indésirables : Hystérectomie.
- étiologie : Lymphoedème, Maladies de la vessie.
- Femelle, Humains, Hystérectomie, Radiothérapie, Roumanie, Soins préopératoires, Tumeurs de l'utérus.
- Wicri :
- geographic : Roumanie.
English descriptors
- KwdEn :
- Female, Hematoma (pathology), Humans, Hysterectomy (adverse effects), Hysterectomy (methods), Lymphedema (etiology), Lymphedema (pathology), Postoperative Complications (pathology), Preoperative Care (methods), Radiotherapy (methods), Romania, Urinary Bladder Diseases (etiology), Urinary Bladder Diseases (pathology), Uterine Neoplasms (surgery), Vaginal Fistula (pathology).
- MESH :
- geographic : Romania.
- adverse effects : Hysterectomy.
- etiology : Lymphedema, Urinary Bladder Diseases.
- methods : Hysterectomy, Preoperative Care, Radiotherapy.
- pathology : Hematoma, Lymphedema, Postoperative Complications, Urinary Bladder Diseases, Vaginal Fistula.
- surgery : Uterine Neoplasms.
- Female, Humans.
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.
Abbreviations: PRS- Piver Rutledge-Smith, II- class II, III- class III
Url:
PubMed: 24653760
PubMed Central: 3956099
Affiliations:
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Le document en format XML
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<term>Hematoma (pathology)</term>
<term>Humans</term>
<term>Hysterectomy (adverse effects)</term>
<term>Hysterectomy (methods)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (pathology)</term>
<term>Postoperative Complications (pathology)</term>
<term>Preoperative Care (methods)</term>
<term>Radiotherapy (methods)</term>
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<term>Hystérectomie ()</term>
<term>Hystérectomie (effets indésirables)</term>
<term>Hématome (anatomopathologie)</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Lymphoedème (étiologie)</term>
<term>Maladies de la vessie (anatomopathologie)</term>
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<term>Soins préopératoires ()</term>
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<term>Postoperative Complications</term>
<term>Urinary Bladder Diseases</term>
<term>Vaginal Fistula</term>
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<front><div type="abstract" xml:lang="en"><p>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. </p>
<p> 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. </p>
<p> 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. </p>
<p> 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. </p>
<p> Abbreviations: PRS- Piver Rutledge-Smith, II- class II, III- class III
</p>
</div>
</front>
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