Postoperative Complications of Radical Hysterectomy with Pelvic Lymphadenectomy as Treatment of Cervical Cancer Stage Ib and

Noh, H T; Song, K I

Abstract

Postoperative complications and correlations were analyzed in 93 cases of type III radical hysterectomy and pelvic lymphadenectomy for cervical cancer stage Ib and IIa patients from January 3, 1992 to December 31, 1996, in the Department of Obstetrics and Gynecology, College of Medicine, Chungnam National University. The result were as follows ; 1. The mean age of patients was 45.9years (range: 25~67). The mean age of stage Ib patients was 45.3 years, and stage IIa was 47.9 years. 2. There was no significant difference in Foley catheter removal day, hemovac removal day, the amount of hemovac drainage, and the amount of transfusion between stage Ib and IIa (P > 0.05). 3. Bladder dysfuntion was the most frequent complication of radical hysterectomy (46.2%). Other complications were severe hemorrhage, 37.6%; defecation difficulty, 37.6%; recurrence, 6.5%; urinary tract infection, 6.5%; wound hematoma, 5.4%; lymphedema, 5.4%; wound infection, 4.3%; ureter stricture, 4.3%; lymphocyst, 3.2%; stump abscess, 2.2%; elevated liver enzyme, 1.1%; and ureterovaginal fistula, 1.1%. 4. In cases of severe hemorrhage the mean amount of transfusion (3.49 +/- 3.82pint vs 0.14pint +/- 0.60pint, p < 0.0001), the total drainge amount of hemovac (1620.73 +/- 1645.05cc vs 985.01 +/- 729.74cc, p = 0.0114) and lymphocyst formation (8.6% vs 0%, p = 0.023)was much more than and more frequent than for a small amount of hemorrhage 6. There was no significant difference in postoperative defecation difficulty, bladder dysfuntion, recurrence, and fistula formation between cervical cancer stage Ib and IIa (p > 0.05). 7. There was more frequent recurrence in patients who had either additional postoperative chemotherapy or radiotherapy, or both, than in patients who had radical hysterectomy alone (13.3% vs 0%, p = 0.03).